ArticleEnvironmental research2021
County-level exposures to greenness and associations with COVID-19 incidence and mortality in the United States.
Article in Environmental research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 2 of them syntheses that pooled it.
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Who cites it
47 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The influence of weather and urban environment characteristics on upper respiratory tract infections: a systematic review.Frontiers in public health · 2025Pooled it
- Effects of the built environment and human factors on the spread of COVID-19: A systematic literature review.The Science of the total environment · 2022Pooled it
- Features of the land use and COVID-19 cases and deaths in urban and land counties in Poland throughout the pandemic: a machine learning approach.BMC public health · 2026Article
- Spatial and neighborhood data in the collaborative cohort of cohorts for COVID-19 Research (C4R).PloS one · 2026Observational
- The role of natural outdoor environment on COVID-19 mortality and hospitalisations among older community-dwellers in the pre-vaccination period: the Register RELOC-AGE cohort study in Sweden.BMC public health · 2025Article
- Environmental Exposures and COVID-19 Experiences in the United States, 2020-2022.International journal of environmental research and public health · 2025Article
- Indirect and direct effects of nighttime light on COVID-19 mortality using satellite image mapping approach.Scientific reports · 2024Article
- Longitudinal Impacts of High Versus Low Greenness on Cardiovascular Disease Conditions.Journal of the American Heart Association · 2024Article
- A Global Meta-Analysis of the Effects of Greenspaces on COVID-19 Infection and Mortality Rates.GeoHealth · 2024Article
- Social-Economic Backgrounds to US County-Based COVID-19 Deaths: PLS-SEM Analysis.Journal of racial and ethnic health disparities · 2024Article
- Assessing Immediate and Lasting Impacts of COVID-19-Induced Isolation on Green Space Usage Patterns.GeoHealth · 2024Article
- Research on the site selection of emergency medical facilities from the perspective of country parks.Scientific reports · 2023Article
- Exploring the spatial pattern of community urban green spaces and COVID-19 risk in Wuhan based on a random forest model.Heliyon · 2023Article
- Methods in Public Health Environmental Justice Research: a Scoping Review from 2018 to 2021.Current environmental health reports · 2023Article
- COVID-19 infection rate but not severity is associated with availability of greenness in the United States.Landscape and urban planning · 2023Article
- The Effects of Urban Living Conditions on Subjective Well-Being: The Case of German Foreign Service Employees.Applied research in quality of life · 2023Article
- Associations between COVID-19 risk, multiple environmental exposures, and housing conditions: A study using individual-level GPS-based real-time sensing data.Applied geography (Sevenoaks, England) · 2023Article
- Natural land cover positively correlates with COVID-19 health outcomes.BMC public health · 2023Article
- Computational decision-support tools for urban design to improve resilience against COVID-19 and other infectious diseases: A systematic review.Progress in planning · 2023Article
- Associations between greenness and predicted COVID-19-like illness incidence in the United States and the United Kingdom.Environmental epidemiology (Philadelphia, Pa.) · 2023Article
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Abstract
backgroundCOVID-19 is an infectious disease that has killed more than 555,000 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.
objectivesWe evaluated whether greenness was related to COVID-19 incidence and mortality in the US.
methodsWe 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 orders.
resultsAn 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 were associated with reduced county-level incidence of COVID-19 in the US as well as reduced county-level COVID-19 mortality rates in densely populated counties.
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