A higher ratio of green spaces means a lower racial disparity in severe acute respiratory syndrome coronavirus 2 infection rates: A nationwide study of the United States

Yi Lu, Long Chen, Xueming Liu, Yuwen Yang, Wenyan Xu, Chris Webster, William C. Sullivan, Bin Jiang

Research output: Working paper


There is striking racial disparity in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rates in the United States. We hypothesize that the disparity is significantly smaller in areas with a higher ratio of green spaces at the county level because green spaces provide health benefits to people of different races through multiple pathways. We suggest that they are an equalizing salutogenic factor, modifying infection exposure. This study used the 135 most urbanized counties across the United States as sample sites. County level data on the SARS-CoV-2 infection rates of blacks and whites in each county were collected. The ratio of green spaces by land-cover type at the county level was calculated from satellite imagery. An ecological hierarchical regression analysis measured cross-sectional associations between racial disparity in infection rates and green space, after controlling for confounding factors. We found a significantly higher infection rate among black individuals compared to white individuals. More importantly, a higher ratio of green spaces at the county level is significantly associated with a lower racial disparity in the SARS-CoV-2 infection rate. Further, we identified four green space factors that have significant negative associations with the racial disparity in SARS-CoV-2 infection rates, including open space in developed areas, forest, shrub-scrub, and herbaceous-grassland.Competing Interest StatementThe authors have declared no competing interest.Funding StatementNo external funding was received. The study was supported by the Faculty Seed Funding for the Virtual Reality Lab of Urban Environments and Human Health.Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:We used publicly available data only.All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.Yes1. The infection data were collected from the county health department portals on July 10, 2020. 2. We calculated the SARS-CoV-2 infection rates and the racial disparity for whites and blacks (numbers of cases per 100k) based on the total white and black populations in each county, respectively, which were retrieved from the 2019 census data. 3.We used three datasets to assess green spaces, namely the National Land Cover Datasets in 2016 (NLCD 2016), the Tree Canopy Cover Datasets of the United States Forest Service (USFS), and NDVI. 4. We obtained the demographic and socioeconomic characteristics from the 2019 census data. 5. County-level pre-existing chronic disease factors were collected from the 2016 2018 interactive heart disease and stroke data collated by the Centers for Disease Control and Prevention.https://www.census.gov/data/tables/time-series/demo/popest/2010s-counties-detail.htmlhttps://www.mrlc.gov/national-land-cover-database-nlcd-2016https://www.census.gov/programs-surveys/acs/news/updates/2019.htmlhttps://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.htmlhttps://www.census.gov/quickfacts/orangecountycalifornia
Original languageEnglish (US)
PublisherCold Spring Harbor Laboratory Press
Number of pages30
StatePublished - Nov 13 2020

Publication series

PublisherCold Spring Harbor Laboratory Press


  • Coronavirus
  • COVID-19
  • severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
  • Novel coronavirus
  • 2019-nCoV
  • Pandemic

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