https://doi.org/10.4081/gh.2022.1017
Association of city-level walkability, accessibility to biking and public transportation and socio-economic features with COVID-19 infection in Massachusetts, USA: An ecological study
Submitted: 9 May 2021
Accepted: 16 August 2021
Published: 14 January 2022
Accepted: 16 August 2021
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Appendix: 288
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
With people restricted to their residences, neighbourhood characteristics may affect behaviour and risk of coronavirus disease 2019 (COVID-19) infection. We aimed to analyse whether neighbourhoods with higher walkability, public transit, biking services and higher socio-economic status were associated with lower COVID-19 infection during the peak of the COVID-19 pandemic in Massachusetts. We used Walk Score®, Bike Score®, and Transit Score® indices to assess the walkability and transportation of 72 cities in Massachusetts, USA based on availability of data and collected the total COVID-19 case numbers of each city up to 10 April 2021. We used univariate and multivariate linear models to analyse the effects of these scores on COVID-19 cases per 100,000 in each city, adjusting for demographic covariates and all covariates, respectively. In the 72 cities studied, the average Walk Score, Transit Score and Bike Score was 48.7, 36.5 and 44.1, respectively, with a total of 426,182 COVID-19 cases. Higher Walk Score, Transit Score, and Bike Score rankings were negatively associated with COVID-19 cases per 100,000 persons (<0.05). Cities with a higher proportion of Hispanic population and a lower median household income were associated with more COVID-19 cases per 100,000 (P<0.05). Higher Walk Score, Transit Score and Bike Score were shown to be protective against COVID-19 transmission, while socio-demographic factors were associated with COVID-19 infection. Understanding the complex relationship of how the structure of the urban environment may constrain commuting patterns for residents and essential workers during COVID-19 would offer potential insights on future pandemic preparedness and response.
Adlakha D, Sallis JF, 2020. Activity-friendly neighbourhoods can benefit non-communicable and infectious diseases. Cities Health 1-5.
DOI: https://doi.org/10.1080/23748834.2020.1783479
Bourouiba L, 2020. Turbulent gas clouds and respiratory pathogen emissions: potential implications for reducing transmission of COVID-19. JAMA 323:1837-8.
DOI: https://doi.org/10.1001/jama.2020.4756
Carr LJ, Dunsiger SI, Marcus BH, 2011. Validation of Walk Score for estimating access to walkable amenities. Br J Sports Med 45:1144.
DOI: https://doi.org/10.1136/bjsm.2009.069609
Chen JT, Waterman PD, Krieger N, 2020. COVID-19 and the unequal surge in mortality rates in Massachusetts, by city/tow and ZIP Code measures of poverty, household crowding, race/ethnicity, and racialized economic segregation. Population. 2020 May 9;25014(B25014_013E):B25014_001E
Chiu M, Rezai M-R, Maclagan Laura C, Austin Peter C, Shah Baiju R, Redelmeier Donald A, Tu Jack V, 2016. Moving to a highly walkable neighborhood and incidence of hypertension: a propensity-score matched cohort study. Environ Health Perspect 124:754-60.
DOI: https://doi.org/10.1289/ehp.1510425
Commonwealth of Massachusetts, 2020a. Safer-at-home advisory. Commonwealth of Massachusetts, Boston, MA, USA.
Commonwealth of Massachusetts, 2020b. COVID-19 response reporting. Commonwealth of Massachusetts, Boston, MA, USA.
Delgado-Ron JA, 2020. Walkability and the COVID-19 pandemic: How compact cities help us combat epidemics, Greenest City Scholars Program, Vancouver, Canada.
Division of Health Care Facility Licensure and Certification, 2020. List of health care facilities licensed or certified by the division. Marlborough, MA, USA.
Duncan DT, 2013. What’s your Walk Score®?: Web-based neighborhood walkability assessment for health promotion and disease prevention. Am J Prev Med 45:244-5.
DOI: https://doi.org/10.1016/j.amepre.2013.04.008
Duncan DT, Aldstadt J, Whalen J, Melly SJ, 2013. Validation of Walk Scores and Transit Scores for estimating neighborhood walkability and transit availability: a small-area analysis. GeoJournal 78:407-16.
DOI: https://doi.org/10.1007/s10708-011-9444-4
Duncan DT, Aldstadt J, Whalen J, Melly SJ, Gortmaker SL, 2011. Validation of Walk Score® for estimating neighborhood walkability: an analysis of four US metropolitan areas. Int J Environ Res Public Health 8:11.
DOI: https://doi.org/10.3390/ijerph8114160
Emeruwa UN, Ona S, Shaman JL, Turitz A, Wright JD, Gyamfi-Bannerman C, Melamed A, 2020. Associations between built environment, neighborhood socioeconomic status, and SARS-CoV-2 infection among pregnant women in New York City. JAMA 324:390-2.
DOI: https://doi.org/10.1001/jama.2020.11370
Ezzati M, Webster CJ, Doyle YG, Rashid S, Owusu G, Leung GM, 2018. Cities for global health. BMJ 363:k3794.
DOI: https://doi.org/10.1136/bmj.k3794
Figueroa JF, Wadhera RK, Lee D, Yeh RW, Sommers BD, 2020. Community-level factors associated with racial and ethnic disparities in COVID-19 rates in Massachusetts: study examines community-level factors associated with racial and ethnic disparities in COVID-19 rates in Massachusetts. Health Aff [Epub ahead of print]. doi:10.1377/hlthaff. 2020.01040.
DOI: https://doi.org/10.1377/hlthaff.2020.01040
Gold JAW, Rossen LM, Ahmad FB, Sutton P, Li Z, Salvatore PP, Coyle JP, DeCuir J, Baack BN, Durant TM, Dominguez KL, Henley SJ, Annor FB, Fuld J, Dee DL, Bhattarai A, Jackson BR, 2020. Race, ethnicity, and age trends in persons who died from COVID-19 - United States, May-August 2020. MMWR Morb Mortal Wkly Rep 69:1517-21.
DOI: https://doi.org/10.15585/mmwr.mm6942e1
Hall CM, Ram Y, 2018. Walk Score® and its potential contribution to the study of active transport and walkability: a critical and systematic review. Transp Res D Transp Environ 61:310-24.
DOI: https://doi.org/10.1016/j.trd.2017.12.018
Hirsch JA, Moore KA, Evenson KR, Rodriguez DA, Roux AVD, 2013. Walk Score® and Transit Score® and walking in the multi-ethnic study of atherosclerosis. Am J Prev Med 45:158-66.
DOI: https://doi.org/10.1016/j.amepre.2013.03.018
Iowa State University, 2021. Urban Percentage of the Population for States, Historical, Iowa Community Indicators Program. Iowa State University of Science and Technology. Available from: https://www.icip.iastate.edu/tables/population/urban-pct-states
Kim B, Rundle AG, Goodwin ATS, Morrison CN, Branas CC, El-Sadr W, Duncan DT, 2021. COVID-19 testing, case, and death rates and spatial socio-demographics in New York City: An ecological analysis as of June 2020. Health Place 68:102539.
DOI: https://doi.org/10.1016/j.healthplace.2021.102539
Lai P-C, Low C-T, Tse W-SC, Tsui C-K, Lee H, Hui P-K, 2013. Risk of tuberculosis in high-rise and high density dwellings: an exploratory spatial analysis. Environ. Pollut. 183:40-5.
DOI: https://doi.org/10.1016/j.envpol.2012.11.025
Lee H, Park SJ, Lee GR, Kim JE, Lee JH, Jung Y, Nam EW, 2020. The relationship between trends in COVID-19 prevalence and traffic levels in South Korea. J Glob Infect Dis 96:399-407.
DOI: https://doi.org/10.1016/j.ijid.2020.05.031
Li S, Ma S, Zhang J, 2021. Association of built environment attributes with the spread of COVID-19 at its initial stage in China. Sustain Cities Soc 67:102752.
DOI: https://doi.org/10.1016/j.scs.2021.102752
Loth L, Gilbert M, Wu J, Czarnecki C, Hidayat M, Xiao X, 2011. Identifying risk factors of highly pathogenic avian influenza (H5N1 subtype) in Indonesia. Prev Vet Med 102:50-8.
DOI: https://doi.org/10.1016/j.prevetmed.2011.06.006
MassGIS (Bureau of Geographic Information), 2020. MassGIS Data: Community Boundaries (Towns) from Survey Points, Boston, MA, USA.
Méline J, Chaix B, Pannier B, Ogedegbe G, Trasande L, Athens J, Duncan DT, 2017. Neighborhood walk score and selected cardiometabolic factors in the French RECORD cohort study. BMC Public Health 17:960.
DOI: https://doi.org/10.1186/s12889-017-4962-8
Muñoz-Price LS, Nattinger AB, Rivera F, Hanson R, Gmehlin CG, Perez A, Singh S, Buchan BW, Ledeboer NA, Pezzin LE, 2020. Racial disparities in incidence and outcomes among patients with COVID-19. JAMA Netw 3:e2021892-e.
DOI: https://doi.org/10.1001/jamanetworkopen.2020.21892
Naranbhai V, Chang CC, Beltran WFG, Miller TE, Astudillo MG, Villalba JA, Yang D, Gelfand J, Bernstein BE, Feldman J, 2020. High seroprevalence of anti-SARS-CoV-2 antibodies in Chelsea, Massachusetts. J. Infect. Dis. [Epub ahead of print].
DOI: https://doi.org/10.1093/infdis/jiaa579
Nguyen QC, Huang Y, Kumar A, Duan H, Keralis JM, Dwivedi P, Meng H-W, Brunisholz KD, Jay J, Javanmardi M, 2020. Using 164 million Google street view images to derive built environment predictors of COVID-19 cases. Int J Environ Res Public Health 17:6359.
DOI: https://doi.org/10.3390/ijerph17176359
Ngwa MC, Liang S, Kracalik IT, Morris L, Blackburn JK, Mbam LM, Ba Pouth SFB, Teboh A, Yang Y, Arabi M, Sugimoto JD, Morris JG, Jr., 2016. Cholera in Cameroon, 2000-2012: Spatial and temporal analysis at the operational (Health District) and sub climate levels. PLoS Negl Trop Dis 10:e0005105.
DOI: https://doi.org/10.1371/journal.pntd.0005105
Nieman DC, Wentz LM, 2019. The compelling link between physical activity and the body’s defense system. J Sport Health Sci 8:201-17.
DOI: https://doi.org/10.1016/j.jshs.2018.09.009
Pucher J, Buehler R, Bassett DR, Dannenberg AL, 2010. Walking and cycling to health: a comparative analysis of city, state, and international data. Am J Public Health 100:1986-92.
DOI: https://doi.org/10.2105/AJPH.2009.189324
Smith KR, Brown BB, Yamada I, Kowaleski-Jones L, Zick CD, Fan JX, 2008. Walkability and body mass index: density, design, and new diversity measures. Am J Prev Med 35:237-44.
DOI: https://doi.org/10.1016/j.amepre.2008.05.028
US Census Bureau, 2019. ACS 5-year estimates data profiles. Available from: data.census.gov
Walk Score advisory board, 2020. Walk Score Methodology. Redfin Corporation, Seattle, WA, USA.
Winters M, Teschke K, Brauer M, Fuller D, 2016. Bike Score®: Associations between urban bikeability and cycling behavior in 24 cities. Int J Behav Nutr Phys Act 13:18.
DOI: https://doi.org/10.1186/s12966-016-0339-0
Zelner J, Trangucci R, Naraharisetti R, Cao A, Malosh R, Broen K, Masters N, Delamater P, 2021. Racial disparities in coronavirus disease 2019 (COVID-19) mortality are driven by unequal infection risks. Clin Infect Dis 72:e88-e95.
DOI: https://doi.org/10.1093/cid/ciaa1723
How to Cite
Wang, Y., Tsai, T. C., Duncan, D., & Ji, J. (2022). Association of city-level walkability, accessibility to biking and public transportation and socio-economic features with COVID-19 infection in Massachusetts, USA: An ecological study. Geospatial Health, 17(s1). https://doi.org/10.4081/gh.2022.1017
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