School of the Environment, Yale University, New Haven, CT, USA.
Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea.
Sci Total Environ. 2021 Jul 20;779:146334. doi: 10.1016/j.scitotenv.2021.146334. Epub 2021 Mar 12.
The United States has the highest numbers of confirmed cases and deaths during the novel coronavirus disease 2019 (COVID-19) pandemic. Previous studies reported that urban residents are more vulnerable to the spread and mortality of COVID-19 than rural residents. However, the pathways through which urban environments affect COVID-19 spread and mortality are unclear. We collected daily data on the number of confirmed cases and deaths of COVID-19 from Mar. 01 to Nov. 16, 2020 for all 91 counties in New York, New Jersey, and Connecticut in the United States. We calculated the COVID-19 incidence %, daily reproduction number, and mortality %, then estimated the associations with urban environment indicators using regression models. COVID-19 outcomes were generally highest in areas with high population density, and this pattern was evident in the early period of epidemic. Among the area-level demographic variables, the percentage of Black or Hispanic residents showed the strongest positive association with COVID-19 outcomes. Higher risk of COVID-19 outcomes was also associated with higher percentage of overcrowded households, uninsured people, and income inequality. The percent elderly, sex ratio (the ratio of males to females), and greenness were negatively associated with risk of COVID-19 outcomes. The results of this study could indicate where resources are most needed.
美国在 2019 年新型冠状病毒病（COVID-19）大流行期间的确诊病例和死亡人数最多。先前的研究报告称，城市居民比农村居民更容易受到 COVID-19 的传播和死亡率的影响。然而，城市环境影响 COVID-19 传播和死亡率的途径尚不清楚。我们从 2020 年 3 月 1 日至 11 月 16 日收集了美国纽约、新泽西和康涅狄格州 91 个县的 COVID-19 确诊病例和死亡人数的每日数据。我们计算了 COVID-19 的发病率%、每日繁殖数和死亡率%，然后使用回归模型估计了与城市环境指标的关联。COVID-19 的结果通常在人口密度高的地区最高，这种模式在疫情早期就很明显。在地区层面的人口变量中，黑人和西班牙裔居民的比例与 COVID-19 的结果呈最强的正相关。高拥挤家庭比例、无保险人群和收入不平等也与 COVID-19 结果的高风险相关。老年人比例、性别比例（男性与女性的比例）和绿化程度与 COVID-19 结果的风险呈负相关。这项研究的结果可以指出资源最需要的地方。
