Effects of housing environments on COVID-19 transmission and mental health revealed by COVID-19 Participant Experience data from the All of Us Research Program in the USA: a case–control study

Abstract

ObjectivesTo examine the association between housing types and COVID-19 infection (or mental health) during the early stages of the pandemic by using the large-scale individual-levelAll of UsResearch Program COVID-19 Participant Experience (COPE) survey data. We hypothesise that housing types with a shared component are associated with elevated COVID-19 infection and subsequent mental health conditions.DesignA retrospective case–control study.SettingSecondary analysis of online surveys conducted in the USA.Participants62 664 participant responses to COPE from May to July 2020.Primary and secondary outcome measuresPrimary outcome measure is the self-reported COVID-19 status, and the secondary outcome measures are anxiety or stress. Both measures were applied for matched cases and controls of the same race, sex, age group and survey version.ResultsA multiple logistic regression analysis revealed that housing types with a shared component are significantly associated with COVID-19 infection (OR=1.19, 95% CI 1.1 to 1.3; p=2×10−4), anxiety (OR=1.26, 95% CI 1.1 to 1.4; p=1.1×10−6) and stress (OR=1.29, 95% CI 1.2 to 1.4; p=4.3×10−10) as compared with free-standing houses, after adjusting for confounding factors. Further, frequent optional shopping or outing trips, another indicator of the built environment, are also associated with COVID-19 infection (OR=1.36, 95% CI 1.1 to 1.8; p=0.02), but not associated with elevated mental health conditions. Confounding factors are controlled in the analysis such as ethnicity, age, social distancing behaviour and house occupancy.ConclusionOur study demonstrates that houses with a shared component tend to have an increased risk of COVID-19 transmission, which consequently leads to high levels of anxiety and stress for their dwellers. The study also suggests the necessity to improve the quality of the built environment such as residential housing and its surroundings through planning, design and management, ensuring a more resilient society that can cope with future pandemics.

The Relationship between the Parameters That Characterize a Built Living Space and the Health Status of Its Inhabitants

“…Numerous research endeavors have delved into the impact of the COVID-19 pandemic on mental well-being. Not having the opportunity to utilize outdoor spaces and experiencing household overcrowding displayed suggestive associations with unfavorable outcomes [80]. Residing in densely populated households, living in solitary conditions, or lacking access to outdoor amenities could play a pivotal role in contributing to diminished mental well-being during a lockdown [81,82].…”

Using Big Data to Assess Park System Performance during the COVID-19 Pandemic

“…However, the global coronavirus disease 2019 (COVID-19) pandemic had drastically compromised the accessibility and operational capacity of urban parks [7][8][9]. It greatly jeopardized physical activities and social interactions across countries [10][11][12][13][14]. There are various types of parks within a city's park system (e.g., metro, community, and neighborhood parks), and they provide different amenities and serve complementary functions [15].…”