Urban Environments and Human Health Lab, HKUrbanLabs, Faculty of Architecture, The University of Hong Kong, Hong Kong SAR; Division of Landscape Architecture, Department of Architecture, The University of Hong Kong, Hong Kong SAR.
Department of Architecture and Civil Engineering, College of Engineering, City University of Hong Kong, Hong Kong SAR.
Sci Total Environ. 2022 Dec 10;851(Pt 2):158333. doi: 10.1016/j.scitotenv.2022.158333. Epub 2022 Aug 28.
The COVID-19 pandemic has caused a huge loss of human life globally. However, few studies investigated the link between exposure to green space and risk of COVID-19 mortality rate, while also distinguishing the effects of various types of green space, considering the spatial distribution of human population and green space, and identifying the optimal buffer distances of nearby green space. It is critical and pressing to fill these significant knowledge gaps to protect and promote billions of people's health and life across the world. This study adopted a negative binomial generalized linear mixed-effects model to examine the association between the ratios of various types of green space, population-weighted exposure to those various types of green space, and COVID-19 mortality rates across 3025 counties in the USA, adjusted for sociodemographic, pre-existing chronic disease, policy and regulation, behavioral, and environmental factors. The findings show that greater exposure to forest was associated with lower COVID-19 mortality rates, while developed open space had mixed associations with COVID-19 mortality rates. Forest outside park had the largest effect size across all buffer distances, followed by forest inside park. The optimal exposure buffer distance was 1 km for forest outside park, with per one-unit of increase in exposure associated with a 9.9 % decrease in COVID-19 mortality rates (95 % confidence interval (CI): 6.9 %-12.8 %). The optimal exposure buffer distance of forest inside park was 400 m, with per one-unit of increase in exposure associated with a 4.7 % decrease in mortality rates (95 % CI: 2.4 %-6.9 %). The results suggest that greater exposure to green spaces, especially to nearby forests, may mitigate the risk of COVID-19 mortality. Although findings of an ecological study cannot be directly used to guide medical interventions, this study may pave a critical new way for future research and practice across multiple disciplines.
新冠疫情在全球范围内造成了巨大的生命损失。然而，很少有研究调查暴露于绿色空间与 COVID-19 死亡率风险之间的联系，同时考虑到人口和绿色空间的空间分布，区分各种类型绿色空间的影响，并确定附近绿色空间的最佳缓冲区距离。填补这些重大知识空白对于保护和促进全球数十亿人的健康和生命至关重要且紧迫。本研究采用负二项广义线性混合效应模型，在美国 3025 个县检查了各种类型绿色空间的比例、人口加权暴露于这些各种类型绿色空间的比例与 COVID-19 死亡率之间的关联，调整了社会人口统计学、预先存在的慢性病、政策和法规、行为和环境因素。研究结果表明，更多地暴露于森林与较低的 COVID-19 死亡率相关，而开发的开放空间与 COVID-19 死亡率呈混合关联。公园外森林的所有缓冲区距离的效应量最大，其次是公园内森林。公园外森林的最佳暴露缓冲区距离为 1 公里，暴露增加一个单位与 COVID-19 死亡率降低 9.9%（95%置信区间：6.9%-12.8%）相关。公园内森林的最佳暴露缓冲区距离为 400 米，暴露增加一个单位与死亡率降低 4.7%（95%置信区间：2.4%-6.9%）相关。研究结果表明，更多地暴露于绿色空间，特别是附近的森林，可能会降低 COVID-19 死亡率的风险。尽管生态研究的结果不能直接用于指导医疗干预，但本研究可能为未来跨多个学科的研究和实践开辟了一条关键的新途径。
