Associations between greenness and predicted COVID-19–like illness incidence in the United States and the United Kingdom
Year: 2023
Type: article
Study design: Observational Study
Abstract: Background: Green spaces may be protective against COVID-19 incidence. They may provide outdoor, ventilated, settings for physical and social activities and therefore decrease transmission risk. We examined the association between neighborhood greenness and COVID-19–like illness incidence using individual-level data. Methods: The study population includes participants enrolled in the COVID Symptom Study smartphone application in the United Kingdom and the United States (March–November 2020). All participants were encouraged to report their current health condition and suspected risk factors for COVID-19. We used a validated symptom-based classifier that predicts COVID-19–like illness. We estimated the Normalized Difference Vegetation Index (NDVI), for each participant’s reported neighborhood of residence for each month, using images from Landsat 8 (30 m2). We used time-varying Cox proportional hazards models stratified by age, country, and calendar month at study entry and adjusted for the individual- and neighborhood-level risk factors. Results: We observed 143,340 cases of predicted COVID-19–like illness among 2,794,029 participants. Neighborhood NDVI was associated with a decreased risk of predicted COVID-19–like illness incidence in the fully adjusted model (hazard ratio = 0.965, 95% confidence interval = 0.960, 0.970, per 0.1 NDVI increase). Stratified analyses showed protective associations among U.K. participants but not among U.S. participants. Associations were slightly stronger for White individuals, for individuals living in rural neighborhoods, and for individuals living in high-income neighborhoods compared to individuals living in low-income neighborhoods. Conclusions: Higher levels of greenness may reduce the risk of predicted COVID-19–like illness incidence, but these associations were not observed in all populations.
Source: Environmental Epidemiology
Language: English
Topic: Urban Green Space and Health
Subfield: Health, Toxicology and Mutagenesis
Field: Environmental Science
Domain: Physical Sciences
Open Access status: gold
Estimated APC paid: $1,200
Funders: Medical Research Council, National Heart, Lung, and Blood Institute, National Cancer Institute, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Environmental Health Sciences, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: Built Environment Assessment through Computer visiON (BEACON): Applying Deep Learning to Street-Level and Satellite Images to Estimate Built Environment Effects on Cardiovascular Health, Impact of Aspirin on the Gut Microbiome and Mucosal Microenvironment, Relationship Between Multiple Environmental Exposures and CVD Incidence and Survival: Vulnerability and Susceptibility, G1817070853, MRC Centre for Environment and Health, Harvard Chan School NIEHS Center for Environmental Health, Early life exposure to the natural, built, and social environments and incident hypertension, Causes and Impact of Minority Stress on Health and Development in Youth, G6200764915, Training Program in Environmental Epidemiology, The effects of environmental exposures on semen quality and the sperm epigenome, Integrating lifecourse approaches, biologic and digital phenotypes in support of heart and lung disease epidemiologic research, Life Course Cancer Epidemiology Cohort in Women
OpenAlex ID: W4319336571