Journal
SUSTAINABLE CITIES AND SOCIETY
Volume 73, Issue -, Pages -Publisher
ELSEVIER
DOI: 10.1016/j.scs.2021.103089
Keywords
Transportation; Built environment; Natural environment; Chronic disease; COVID-19 mortality; Simulation; Random parameters; Path analysis
Categories
Funding
- Department of Urban Studies and Planning at UC San Diego
- US Environmental Protection Agency's Office of Research and Development and Smart Growth Office
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Recent research highlights the negative and significant relationships between built and natural environment features and COVID-19 mortality, emphasizing the importance of chronic diseases in assessing the impact of community design on COVID-19 mortality. The study also reveals significant heterogeneity in the relationships between COVID-19 mortality, obesity, and key correlates, emphasizing the need to consider these factors when examining the relationship between built environment and COVID-19 transmission. Overall, creating walkable environments with greenspace is associated with reduced risk of chronic disease and/or COVID-19 infection and mortality.
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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