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Environmental Exposures and COVID-19 Experiences in the United States, 2020–2022

Author

Listed:
  • Elyssa Anneser

    (Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA)

  • Thomas J. Stopka

    (Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA
    Tufts Clinical and Translational Sciences Institute, Boston, MA 02111, USA)

  • Elena N. Naumova

    (Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA
    Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, MA 02155, USA
    Division of Nutrition Epidemiology and Data Science, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA)

  • Keith R. Spangler

    (Department of Environmental Health, Boston University School of Public Health, Boston, MA 02118, USA)

  • Kevin J. Lane

    (Department of Environmental Health, Boston University School of Public Health, Boston, MA 02118, USA)

  • Andrea Acevedo

    (Department of Community Health, Tufts University School of Arts and Sciences, Medford, MA 02155, USA)

  • Jeffrey K. Griffiths

    (Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA
    Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, MA 02155, USA
    Department of Infectious Disease and Global Health, Cummings School of Veterinary Medicine, Tufts University, Grafton, MA 01536, USA
    Department of Medicine, Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA 02111, USA)

  • Yan Lin

    (Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA)

  • Peter Levine

    (Jonathan M. Tisch College of Civic Life, Tufts University, Medford, MA 02155, USA)

  • Laura Corlin

    (Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA
    Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, MA 02155, USA)

Abstract

Certain environmental exposures 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 for adults in the United States). 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, health impacts, 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, and more heatwaves) were associated with increased vaccination willingness. Air pollution exposure in 2020 was positively associated with the 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 suggest that intersectional equity issues affecting the likelihood of exposure to adverse environmental conditions are also associated with health-related outcomes.

Suggested Citation

  • Elyssa Anneser & Thomas J. Stopka & Elena N. Naumova & Keith R. Spangler & Kevin J. Lane & Andrea Acevedo & Jeffrey K. Griffiths & Yan Lin & Peter Levine & Laura Corlin, 2025. "Environmental Exposures and COVID-19 Experiences in the United States, 2020–2022," IJERPH, MDPI, vol. 22(8), pages 1-23, August.
    • Handle: RePEc:gam:jijerp:v:22:y:2025:i:8:p:1280-:d:1725612
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