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Treating two pandemics for the price of one: Chronic and infectious disease impacts of the built and natural environment.
Frank, Lawrence D; Wali, Behram.
  • Frank LD; Urban Studies and Planning, University of California at San Diego, Social Sciences Public Engagement Building (PEB), 9625 Scholars Drive North MC 0517, PEB La Jolla, CA, 92093, USA.
  • Wali B; Urban Design 4 Health, Inc., 24 Jackie Circle East, Rochester, NY, 14612, USA.
Sustain Cities Soc ; 73: 103089, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1267922
ABSTRACT
Compact walkable environments with greenspace support physical activity and reduce the risk for depression and several obesity-related chronic diseases, including diabetes and heart disease. Recent evidence confirms that these chronic diseases increase the severity of COVID-19 infection and mortality risk. Conversely, denser transit supportive environments may increase risk of exposure to COVID-19 suggesting the potential for contrasting chronic versus infectious disease impacts of community design. A handful of recent studies have examined links between density and COVID-19 mortality rates reporting conflicting results. Population density has been used as a surrogate of urban form to capture the degree of walkability and public transit versus private vehicle travel demand. The current study employs a broader range of built environment features (density, design, and destination accessibility) and assesses how chronic disease mediates the relationship between built and natural environment and COVID-19 mortality. Negative and significant relationships are observed between built and natural environment features and COVID-19 mortality when accounting for the mediating effect of chronic disease. Findings underscore the importance of chronic disease when assessing relationships between COVID-19 mortality and community design. Based on a rigorous simulation-assisted random parameter path analysis framework, we further find that the relationships between COVID-19 mortality, obesity, and key correlates exhibit significant heterogeneity. Ignoring this heterogeneity in highly aggregate spatial data can lead to incorrect conclusions with regards to the relationship between built environment and COVID-19 transmission. Results presented here suggest that creating walkable environments with greenspace is associated with reduced risk of chronic disease and/or COVID-19 infection and mortality.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Health economic evaluation / Randomized controlled trials Language: English Journal: Sustain Cities Soc Year: 2021 Document Type: Article Affiliation country: J.scs.2021.103089

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Health economic evaluation / Randomized controlled trials Language: English Journal: Sustain Cities Soc Year: 2021 Document Type: Article Affiliation country: J.scs.2021.103089