STEER researcher Alexandra Rizaldi investigates neighborhood characteristics associated with COVID-19 in Philadelphia

My name is Alex Rizaldi, and I am from Chadds Ford, PA (a Philadelphia suburb). I am a rising sophomore at the University of Pennsylvania studying biology on the pre-med track. As my first research experience and my first in-depth exposure to the environmental health field, STEER has been monumental in helping me determine my academic and career paths. This summer, under the mentorship of Dr. Blanca Himes, I have been investigating neighborhood characteristics that may be associated with COVID-19 in Philadelphia.

What is your summer research project?

COVID-19, the infectious disease caused by the novel coronavirus SARS-CoV-2, has infected 5.3 million Americans and over 30,000 Philadelphians as of August 17, 2020. What is unique about COVID-19 is that it affects people in a variety of ways; those who test positive may have no symptoms, suffer from nausea or loss of smell, or unfortunately experience severe outcomes like hospitalization or death. However, what is not unique about COVID-19 is that racial and socioeconomic disparities have been reported, with minority and low-income populations being disproportionately affected by the disease. With all of this in mind, there were two goals of my research. First, I wanted to see

what areas in Philadelphia have worse COVID-19 outcomes (positivity, testing rate, hospitalization rate, death rate) compared to others. Second, I wanted to see what neighborhood characteristics (prevalence of medical conditions like asthma, health behaviors like smoking, socioeconomic status, demographics) may be associated with the areas of worse COVID-19 outcomes. Using public data sources including the Pennsylvania Department of Health, the Philadelphia Department of Public Health, and the Public Health Management Corporation, I calculated zip code-level metrics to visualize and analyze in R. For these metrics, I also excluded COVID-19 cases and deaths attributed to nursing homes and prisons, as disease transmission in those congregate living facilities do not accurately reflect community spread in the underlying population. From my preliminary analysis using bivariate and lasso regressions, educational attainment and household size seem to be most associated with COVID-19 outcomes. However, I plan to conduct additional analysis and expand into surrounding counties in Southeast Pennsylvania to further investigate and validate these associations.

Maps showing COVID-19 positive test rates (left) and percent of adults with graduate education (right) by zip code in Philadelphia.

What are the implications of your research?

The COVID-19 pandemic has exposed the shortcomings of our healthcare system and has emphasized the need to prioritize public health. This type of epidemiology and health disparities research is vital in informing policy decisions that are rooted in science and accurately portray the needs of the community. By identifying subsets of the Philadelphia population that are being disproportionately affected by COVID-19, in addition to the neighborhood characteristics associated with specific COVID-19 outcomes, the city will be able to efficiently address specific populations that require greater access to testing, health care, and education.

What new skills have you gained through your research?

Conducting an independent project from start to finish has been incredibly valuable in immersing myself in the research process—from developing a research question, to manipulating (and learning the limitations of) public data, to writing and presenting my results. I have gained proficiency in QGIS and primarily R programming, specifically in data manipulation, geocoding, data visualization, and regression analysis. This experience has also helped me develop my leadership and communication skills and build relationships with guest lecturers, program directors, and fellow interns despite the fully virtual format.

A less concrete, but equally important, skill that I have gained this summer is an awareness of the intersection between clinical work, policy, research. Through my research this summer, I have been able to translate the health disparities I have observed as a campus EMT, COVID-19 response volunteer, and free clinic intake worker to the neighborhood-level research and mapping I have done for Philadelphia. And more importantly, now I will always consider the social determinants of health and environmental exposures of the patients I encounter in my clinical work. With all of these new insights and a reaffirmed desire to pursue a career in the medical field, I am very excited to continue with my research with the Himes Lab following the STEER program end.