County-level exposures to greenness and associations with COVID-19 incidence and mortality in the United States.
Coronavirus
environmental health
epidemiology
green space
Journal
medRxiv : the preprint server for health sciences
Titre abrégé: medRxiv
Pays: United States
ID NLM: 101767986
Informations de publication
Date de publication:
16 Nov 2020
16 Nov 2020
Historique:
pubmed:
11
9
2020
medline:
11
9
2020
entrez:
10
9
2020
Statut:
epublish
Résumé
COVID-19 is an infectious disease that has killed more than 246,000 people in the US. During a time of social distancing measures and increasing social isolation, green spaces may be a crucial factor to maintain a physically and socially active lifestyle while not increasing risk of infection. We evaluated whether greenness is related to COVID-19 incidence and mortality in the United States. We downloaded data on COVID-19 cases and deaths for each US county up through June 7, 2020, from Johns Hopkins University, Center for Systems Science and Engineering Coronavirus Resource Center. We used April-May 2020 Normalized Difference Vegetation Index (NDVI) data, to represent the greenness exposure during the initial COVID-19 outbreak in the US. We fitted negative binomial mixed models to evaluate associations of NDVI with COVID-19 incidence and mortality, adjusting for potential confounders such as county-level demographics, epidemic stage, and other environmental factors. We evaluated whether the associations were modified by population density, proportion of Black residents, median home value, and issuance of stay-at-home order. An increase of 0.1 in NDVI was associated with a 6% (95% Confidence Interval: 3%, 10%) decrease in COVID-19 incidence rate after adjustment for potential confounders. Associations with COVID-19 incidence were stronger in counties with high population density and in counties with stay-at-home orders. Greenness was not associated with COVID-19 mortality in all counties; however, it was protective in counties with higher population density. Discussion: Exposures to NDVI had beneficial impacts on county-level incidence of COVID-19 in the US and may have reduced county-level COVID-19 mortality rates, especially in densely populated counties.
Sections du résumé
BACKGROUND
BACKGROUND
COVID-19 is an infectious disease that has killed more than 246,000 people in the US. During a time of social distancing measures and increasing social isolation, green spaces may be a crucial factor to maintain a physically and socially active lifestyle while not increasing risk of infection.
OBJECTIVES
OBJECTIVE
We evaluated whether greenness is related to COVID-19 incidence and mortality in the United States.
METHODS
METHODS
We downloaded data on COVID-19 cases and deaths for each US county up through June 7, 2020, from Johns Hopkins University, Center for Systems Science and Engineering Coronavirus Resource Center. We used April-May 2020 Normalized Difference Vegetation Index (NDVI) data, to represent the greenness exposure during the initial COVID-19 outbreak in the US. We fitted negative binomial mixed models to evaluate associations of NDVI with COVID-19 incidence and mortality, adjusting for potential confounders such as county-level demographics, epidemic stage, and other environmental factors. We evaluated whether the associations were modified by population density, proportion of Black residents, median home value, and issuance of stay-at-home order.
RESULTS
RESULTS
An increase of 0.1 in NDVI was associated with a 6% (95% Confidence Interval: 3%, 10%) decrease in COVID-19 incidence rate after adjustment for potential confounders. Associations with COVID-19 incidence were stronger in counties with high population density and in counties with stay-at-home orders. Greenness was not associated with COVID-19 mortality in all counties; however, it was protective in counties with higher population density. Discussion: Exposures to NDVI had beneficial impacts on county-level incidence of COVID-19 in the US and may have reduced county-level COVID-19 mortality rates, especially in densely populated counties.
Identifiants
pubmed: 32908990
doi: 10.1101/2020.08.26.20181644
pmc: PMC7480038
pii:
doi:
Types de publication
Preprint
Langues
eng
Subventions
Organisme : NIEHS NIH HHS
ID : P30 ES000002
Pays : United States
Organisme : NIEHS NIH HHS
ID : R01 ES028033
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL150119
Pays : United States
Commentaires et corrections
Type : UpdateIn
Déclaration de conflit d'intérêts
Declaration of interest The authors declare they have no actual or potential competing financial interests.