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New York City (NYC), in the early stages of the pandemic, had the highest number and incidence of COVID-19 cases and deaths in US cities The foundation of this public health catastrophe lies in the overall public health and socioeconomic (SE) structure of the city Premature (below age 65) mortality rate indicates background public health In year 2000, community districts (CDs) with low population percent over age 65 had high incidence of HIV mortality and its three associated mortalities (homicide, drugs, liver disease) as well as high poverty rate, high unemployment, low median income, and low percent adults with college or higher degrees NYC Health Department’s use of age 65 as the benchmark for premature death departs from that of the CDC’s National Center for Health Statistics which uses age 75 This departure contributes to an underestimation of premature mortality rates and of public health deficiencies This study examines 2017 premature mortality rate of CDs, health outcomes associated with it, and contextual SE factors Four health outcomes associated with premature mortality rate in multivariate regression: HIV, diabetes, and drug mortality rates and percent of births to teenagers SE factors associated with premature mortality rate and its health guild were serious housing violations per 1000 units, unemployment rate, poverty rate, percent adults with college or higher degrees (the only negative association), and indicators of segregation Much of the context of year 2000 patterns of mortality disparities remained in 2017 The coronavirus pandemic plays out in NYC in this SE/public health system Old age and age-related chronic conditions emerged as raised risks for serious COVID injury and death Premature mortality indicates a population’s rapidity of physiological aging from structural stress: ‘weathering’ © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG
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