County-level exposures to greenness and associations with COVID-19 incidence and mortality in the United States
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: We evaluated whether greenness is related to COVID-19 incidence and mortality in the United States.
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: 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.
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2020 |
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| Enthalten in: |
medRxiv : the preprint server for health sciences - (2020) vom: 16. Nov. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Klompmaker, Jochem O [VerfasserIn] |
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| Links: |
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| Themen: |
Coronavirus |
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| Anmerkungen: |
Date Revised 03.04.2024 published: Electronic UpdateIn: Environ Res. 2021 Aug;199:111331. - PMID 34004166 Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1101/2020.08.26.20181644 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM31481230X |
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| 041 | |a eng | ||
| 100 | 1 | |a Klompmaker, Jochem O |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a County-level exposures to greenness and associations with COVID-19 incidence and mortality in the United States |
| 264 | 1 | |c 2020 | |
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| 500 | |a Date Revised 03.04.2024 | ||
| 500 | |a published: Electronic | ||
| 500 | |a UpdateIn: Environ Res. 2021 Aug;199:111331. - PMID 34004166 | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a 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 | ||
| 520 | |a OBJECTIVES: We evaluated whether greenness is related to COVID-19 incidence and mortality in the United States | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Preprint | |
| 650 | 4 | |a Coronavirus | |
| 650 | 4 | |a environmental health | |
| 650 | 4 | |a epidemiology | |
| 650 | 4 | |a green space | |
| 700 | 1 | |a Hart, Jaime E |e verfasserin |4 aut | |
| 700 | 1 | |a Holland, Isabel |e verfasserin |4 aut | |
| 700 | 1 | |a Sabath, M Benjamin |e verfasserin |4 aut | |
| 700 | 1 | |a Wu, Xiao |e verfasserin |4 aut | |
| 700 | 1 | |a Laden, Francine |e verfasserin |4 aut | |
| 700 | 1 | |a Dominici, Francesca |e verfasserin |4 aut | |
| 700 | 1 | |a James, Peter |e verfasserin |4 aut | |
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| 856 | 4 | 0 | |u http://dx.doi.org/10.1101/2020.08.26.20181644 |3 Volltext |
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