| Autor: |
Anneser E; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA., Stopka TJ; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA.; Tufts Clinical and Translational Sciences Institute, Boston, MA, USA., Naumova EN; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA.; Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, MA, USA.; Division of Nutrition Epidemiology and Data Science, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA., Spangler KR; Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA., Lane KJ; Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA., Acevedo A; Department of Community Health, Tufts University School of Arts and Sciences, Medford, MA, USA., Griffiths JK; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA.; Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, MA, USA.; Department of Infectious Disease and Global Health, Tufts University Cummings School of Veterinary Medicine, Grafton, MA, USA.; Division of Geographic Medicine and Infectious Diseases, Department of Medicine, Tufts Medical Center, Boston, MA., Lin Y; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA., Levine P; Jonathan Tisch College of Civic Life, Tufts University, Medford, MA, USA., Corlin L; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA.; Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, MA, USA. |
| Abstrakt: |
Certain environmental exposures, such as air pollution, are associated with COVID-19 incidence and mortality. To determine whether environmental context is associated with other COVID-19 experiences, we used data from the nationally representative Tufts Equity in Health, Wealth, and Civic Engagement Study data (n=1785; three survey waves 2020-2022). Environmental context was assessed using self-reported climate stress and county-level air pollution, greenness, toxic release inventory site, and heatwave data. Self-reported COVID-19 experiences included willingness to vaccinate against COVID-19, health impacts from COVID-19, receiving assistance for COVID-19, and provisioning assistance for COVID-19. Self-reported climate stress in 2020 or 2021 was associated with increased COVID-19 vaccination willingness by 2022 (odds ratio [OR] = 2.35; 95% confidence interval [CI] = 1.47, 3.76), even after adjusting for political affiliation (OR = 1.79; 95% CI = 1.09, 2.93). Self-reported climate stress in 2020 was also associated with increased likelihood of receiving COVID-19 assistance by 2021 (OR = 1.89; 95% CI = 1.29, 2.78). County-level exposures (i.e., less greenness, more toxic release inventory sites, more heatwaves) were associated with increased vaccination willingness. Air pollution exposure in 2020 was positively associated with likelihood of provisioning COVID-19 assistance in 2020 (OR = 1.16 per μg/m 3 ; 95% CI = 1.02, 1.32). Associations between certain environmental exposures and certain COVID-19 outcomes were stronger among those who identify as a race/ethnicity other than non-Hispanic White and among those who reported experiencing discrimination; however, these trends were not consistent. A latent variable representing a summary construct for environmental context was associated with COVID-19 vaccination willingness. Our results add to the growing body of literature suggesting that intersectional equity issues affecting likelihood of exposure to adverse environmental conditions are also associated with health-related outcomes. |
