ArticleEnvironmental research2023
Association of greenness with COVID-19 deaths in India: An ecological study at district level.
Article in Environmental research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 12 citations in OpenAlex.
- 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
- Ambient Air Pollution and COVID-19 in California.Research report (Health Effects Institute) · 2026Article
- 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
- Effects of Residential Greenness on Influenza Virus Infection in 1,012,430 People: A Nationwide Individual-Level Study in China.Environment & health (Washington, D.C.) · 2025Article
- A Global Meta-Analysis of the Effects of Greenspaces on COVID-19 Infection and Mortality Rates.GeoHealth · 2024Article
- Tracing the COVID-19 spread pattern in India through a GIS-based spatio-temporal analysis of interconnected clusters.Scientific reports · 2024Article
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Authors and funding
4 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe world has witnessed a colossal death toll due to the novel coronavirus disease-2019 (COVID-19). A few environmental epidemiology studies have identified association of environmental factors (air pollution, greenness, temperature, etc.) with COVID-19 incidence and mortality, particularly in developed countries. India, being one of the most severely affected countries by the pandemic, still has a dearth of research exploring the linkages of environment and COVID-19 pandemic.
objectivesWe evaluate whether district-level greenness exposure is associated with a reduced risk of COVID-19 deaths in India.
methodsWe used average normalized difference vegetation index (NDVI) from January to March 2019, derived by Oceansat-2 satellite, to represent district-level greenness exposure. COVID-19 death counts were obtained through May 1, 2021 (around the peak of the second wave) from an open portal: covid19india.org. We used hierarchical generalized negative binomial regressions to check the associations of greenness with COVID-19 death counts. Analyses were adjusted for air pollution (PM
resultsOur analyses found a significant association between greenness and reduced risk of COVID-19 deaths. Compared to the districts with the lowest NDVI (quintile 1), districts within quintiles 3, 4, and 5 have respectively, around 32% [MRR = 0.68 (95% CI: 0.51, 0.88)], 39% [MRR = 0.61 (95% CI: 0.46, 0.80)], and 47% [MRR = 0.53 (95% CI: 0.40, 0.71)] reduced risk of COVID-19 deaths. The association remains consistent for analyses restricted to districts with a rather good overall death registration (>80%).
conclusionThough cause-of-death statistics are limited, we confirm that exposure to greenness was associated with reduced district-level COVID-19 deaths in India. However, material deprivation and air pollution modify this association.
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