County-level exposures to greenness and associations with COVID-19 incidence and mortality in the United States.
Coronavirus
Environmental health
Epidemiology
Green space
Journal
Environmental research
ISSN: 1096-0953
Titre abrégé: Environ Res
Pays: Netherlands
ID NLM: 0147621
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
received:
16
11
2020
revised:
10
05
2021
accepted:
11
05
2021
pubmed:
19
5
2021
medline:
16
6
2021
entrez:
18
5
2021
Statut:
ppublish
Résumé
COVID-19 is an infectious disease that has killed more than 555,000 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 was related to COVID-19 incidence and mortality in the US. 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 orders. 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. Exposures to NDVI were associated with reduced county-level incidence of COVID-19 in the US as well as reduced county-level COVID-19 mortality rates in densely populated counties.
Sections du résumé
BACKGROUND
COVID-19 is an infectious disease that has killed more than 555,000 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
We evaluated whether greenness was related to COVID-19 incidence and mortality in the US.
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 orders.
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 were associated with reduced county-level incidence of COVID-19 in the US as well as reduced county-level COVID-19 mortality rates in densely populated counties.
Identifiants
pubmed: 34004166
pii: S0013-9351(21)00625-3
doi: 10.1016/j.envres.2021.111331
pmc: PMC8123933
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
111331Subventions
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 : UpdateOf
Informations de copyright
Copyright © 2021 Elsevier Inc. All rights reserved.
Références
Lancet Public Health. 2020 May;5(5):e261-e270
pubmed: 32220655
PLoS One. 2021 Jul 29;16(7):e0255212
pubmed: 34324570
Environ Health Perspect. 2019 Feb;127(2):27001
pubmed: 30735068
Environ Res. 2020 Dec;191:110052
pubmed: 32860780
Int J Environ Res Public Health. 2020 May 14;17(10):
pubmed: 32422948
Curr Epidemiol Rep. 2015 Jun;2(2):131-142
pubmed: 26185745
Environ Res. 2018 Oct;166:628-637
pubmed: 29982151
Inhal Toxicol. 2007 Nov;19(14):1135-46
pubmed: 17987465
Indoor Air. 2021 May;31(3):639-645
pubmed: 33131151
J For Res (Harbin). 2021;32(2):553-567
pubmed: 33204057
Lancet Planet Health. 2017 Oct;1(7):e289-e297
pubmed: 29851627
Environ Sci Technol. 2019 Mar 5;53(5):2595-2611
pubmed: 30698001
SN Compr Clin Med. 2020;2(4):383-387
pubmed: 32296757
J Adolesc Health. 2018 Apr;62(4):488-495
pubmed: 29273301
Eur Respir J. 2020 Jul 30;56(1):
pubmed: 32586882
Environ Res. 2020 Dec;191:110155
pubmed: 32871151
Ann Epidemiol. 2020 Jul;47:37-44
pubmed: 32419766
Emerg Infect Dis. 2019 Jan;25(1):1-4
pubmed: 30560777
Int J Surg. 2020 Apr;76:71-76
pubmed: 32112977
Sci Total Environ. 2020 Aug 10;729:138474
pubmed: 32498152
Sci Adv. 2020 Nov 4;6(45):
pubmed: 33148655
Lancet Infect Dis. 2004 Nov;4(11):704-8
pubmed: 15522683
Lancet Infect Dis. 2020 May;20(5):533-534
pubmed: 32087114
Int J Environ Res Public Health. 2021 Jan 08;18(2):
pubmed: 33430024
BJGP Open. 2020 Aug 25;4(3):
pubmed: 32636204
Annu Rev Virol. 2020 Sep 29;7(1):83-101
pubmed: 32196426
Environ Health Perspect. 2020 Sep;128(9):95001
pubmed: 32902328
Environ Int. 2017 Nov;108:176-184
pubmed: 28863390
Science. 1984 Apr 27;224(4647):420-1
pubmed: 6143402
Curr Environ Health Rep. 2018 Mar;5(1):77-87
pubmed: 29392643