Chen Kelly, Klompmaker Jochem O, Roscoe Charlotte J, Nguyen Long H, Drew David A, James Peter, Laden Francine, Fecht Daniela, Wang Weiyi, Gulliver John, Wolf Jonathan, Steves Claire J, Spector Tim D, Chan Andy T, Hart Jaime E
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Environ Epidemiol. 2023 Feb 7;7(1):e244. doi: 10.1097/EE9.0000000000000244. eCollection 2023 Feb.
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.
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 m). 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.
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 ). 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.
Higher levels of greenness may reduce the risk of predicted COVID-19-like illness incidence, but these associations were not observed in all populations.
绿地可能对新冠病毒感染有防护作用。它们可以提供户外、通风的场所用于体育和社交活动，从而降低传播风险。我们使用个体层面的数据研究了邻里绿化与类新冠疾病发病率之间的关联。
研究人群包括在英国和美国（2020年3月至11月）参与新冠症状研究智能手机应用程序的参与者。鼓励所有参与者报告他们当前的健康状况和疑似新冠病毒感染风险因素。我们使用经过验证的基于症状的分类器来预测类新冠疾病。我们利用陆地卫星8号（30米分辨率）的图像，为每个参与者每月报告的居住邻里估算归一化植被指数（NDVI）。我们使用随时间变化的Cox比例风险模型，按研究入组时的年龄、国家和日历月份进行分层，并对个体和邻里层面的风险因素进行调整。
在2,794,029名参与者中，我们观察到143,340例预测的类新冠疾病病例。在完全调整模型中，邻里NDVI与预测的类新冠疾病发病率风险降低相关。分层分析显示，英国参与者之间存在保护关联，而美国参与者之间没有。与低收入社区的个体相比，白人个体、居住在农村社区的个体以及居住在高收入社区的个体之间的关联略强。
更高水平的绿化可能会降低预测的类新冠疾病发病率风险，但并非在所有人群中都观察到这些关联。
