The Creation of a Multidomain Neighborhood Environmental Vulnerability Index Across an Urban Center

Compared to previous studies that have typically used a single summary score, we aimed to construct a multidomain neighborhood environmental vulnerability index (NEVI) to characterize the magnitude and variability of area-level factors with the potential to modify the health effects of environmental pollutants. Using the Toxicological Prioritization Index framework and data from the 2015-2019 U.S. Census American Community Survey and the 2020 CDC PLACES Project, we quantified census tract-level vulnerability overall and in 4 primary domains (demographic, economic, residential, and health status), 24 subdomains, and 54 distinct area-level features for New York City (NYC). Overall and domain-specific indices were calculated by summing standardized feature values within the subdomains and then aggregating and weighting subdomains within equally-weighted primary domains. In citywide comparisons, NEVI was correlated with both the Neighborhood Deprivation Index (r = 0.91) and the Social Vulnerability Index (r = 0.87) but provided additional information on features contributing to vulnerability. Vulnerability varied spatially across NYC, and hierarchical cluster analysis using subdomain scores revealed six patterns of vulnerability across domains: 1) low in all, 2) primarily low except residential, 3) medium in all, 4) high demographic, economic, and residential 5) high economic, residential, and health status, and 6) high demographic, economic and health status. Created using a tool that offers flexibility for theory-based construction, NEVI provided detailed metrics of vulnerability across domains that can inform targeted research and public health interventions aimed at reducing the health impacts from environmental exposures across an urban center. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement Research described in this article was conducted under contract to the Health Effects Institute (HEI), an organization jointly funded by the United States Environmental Protection Agency (EPA) (Assistance Award No. CR-83998101) and certain motor vehicle and engine manufacturers. (#4985-RFA20-1B/21-8) The contents of this article do not necessarily reflect the views of HEI, or its sponsors, nor do they necessarily reflect the views and policies of the EPA or motor vehicle and engine manufacturers. Additional funding was received from the National Institute of Environmental Health Sciences, (T32ES007322 (SPU), R00ES027022 (JAS, SPU), P30ES009089 (SLD, JAS), P30ES023515 (PES), and R01ES030717 (PES)), National Heart Lung and Blood Institute (K01HL140216 (SLD)), National Institute of Diabetes, Digestive and Kidney Disorders (K01DK107791 (SSA), P30DK111022 (EC)) and the Robert Wood Johnson Foundation-Amos Medical Faculty Development Award (SLD).) This study is a product of the HD4NYC project, a multi-institutional research platform to improve health equity in NYC, funded by Robert Wood Johnson Foundation to NYC DOHMH and New York Academy of Medicine (NYAM). Although the research described in this article was supported by an initiative funded in part by Robert Wood Johnson Foundation, it has not been subjected to review and, therefore, does not necessarily reflect the views of the foundation, and no official endorsement should be inferred. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data and code produced are available online.