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The neighborhood built environment and COVID-19 hospitalizations

Rigolon et al., PLOS ONE, doi:10.1371/journal.pone.0286119
Jun 2023  
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Analysis of neighborhood built environment characteristics in the USA with 18,042 COVID+ individuals, showing lower risk of hospitalization with higher walkability and higher bikeability scores.
Rigolon et al., 14 Jun 2023, retrospective, USA, peer-reviewed, 9 authors, study period 1 May, 2020 - 31 December, 2020.
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The neighborhood built environment and COVID-19 hospitalizations
Alessandro Rigolon, Jeremy Németh, Brenn Anderson-Gregson, Ana Rae Miller, Priyanka Desouza, Brian Montague, Cory Hussain, Kristine M Erlandson, Sarah E Rowan
PLOS ONE, doi:10.1371/journal.pone.0286119
Research on the associations between the built environment and COVID-19 outcomes has mostly focused on incidence and mortality. Also, few studies on the built environment and COVID-19 have controlled for individual-level characteristics across large samples. In this study, we examine whether neighborhood built environment characteristics are associated with hospitalization in a cohort of 18,042 individuals who tested positive for SARS-CoV-2 between May and December 2020 in the Denver metropolitan area, USA. We use Poisson models with robust standard errors that control for spatial dependence and several individual-level demographic characteristics and comorbidity conditions. In multivariate models, we find that among individuals with SARS-CoV-2 infection, those living in multi-family housing units and/or in places with higher particulate matter (PM 2.5 ) have a higher incident rate ratio (IRR) of hospitalization. We also find that higher walkability, higher bikeability, and lower public transit access are linked to a lower IRR of hospitalization. In multivariate models, we did not find associations between green space measures and the IRR of hospitalization. Results for non-Hispanic white and Latinx individuals highlight substantial differences: higher PM 2.5 levels have stronger positive associations with the IRR of hospitalization for Latinx individuals, and density and overcrowding show stronger associations for non-Hispanic white individuals. Our results show that the neighborhood built environment might pose an independent risk for COVID-19 hospitalization. Our results may inform public health and urban planning initiatives to lower the risk of hospitalization linked to COVID-19 and other respiratory pathogens.
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