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

Elyssa Anneser, Thomas J. Stopka, Elena N. Naumova, Keith R. Spangler, Kevin J. Lane, Andrea Acevedo, Jeffrey K. Griffiths, Yan Lin, Peter Levine and Laura Corlin ()
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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
Elena N. Naumova: Department of Public Health and Community Medicine, Tufts University School of Medicine, 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
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

IJERPH, 2025, vol. 22, issue 8, 1-23

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.

Keywords: environmental equity; climate stress; COVID-19; vaccination willingness; COVID-19 assistance (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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