Built environment’s impact on COVID-19 transmission and mental health revealed by COVID-19 Participant Experience data from the All of Us Research Program

  1. Wenting Luo
  2. Edwin Baldwin
  3. Anna Yi Jiang
  4. Shujuan Li
  5. Bo Yang
  6. Haiquan Li

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Abstract

Objectives

The coronavirus disease 2019 (COVID-19) pandemic has led to millions of deaths. Effectively cutting the transmission of COVID-19 is essential to reduce the impact. Previous studies have observed the potential relationship between the built environment and COVID-19 transmission; however, to date, stringent studies investigating these relationships at the individual level are still insufficient. Here, we aim to examine the relationship between household types and COVID-19 infection (or mental health) during the early stages of the pandemic by using the All of Us Research Program CO VID-19 P articipant E xperience (COPE) survey data.

Design

Based on 62,664 participants’ responses to COPE from May to July 2020, we matched the cases of self-reported COVID-19 status, anxiety, or stress, with controls of the same race, sex, age group, and survey version. We conducted multiple logistic regressions between one of the outcomes and household type under the adjustment of other related covariates, such as ethnicity, age, social distancing behavior, and house occupancy.

Results

Household type with a shared component was 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 to free-standing houses after adjusting for the abovementioned confounding factors. Further, frequent nonessential shopping or outings, another indicator of the built environment, was 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.

Conclusion

Our study demonstrated that the built environment of houses with a shared component tends to increase the risk of COVID-19 transmission, which consequently led to more anxiety and stress for their dwellers. It also suggested the necessity to improve the quality of the built environment through planning, design, and management toward a more resilient society in coping with future pandemics.

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    SciScore for 10.1101/2022.04.05.22273358: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    At the time of our analysis, we took advantage of the first three versions (May, June, and July 2020) of the COPE data consisting of 62,664 participants in AllofUsRP Dataset v4 where household type information was available.
    COPE
    suggested: (COPE, RRID:SCR_009153)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The results of the study should be interpreted with caution due to various limitations: 1) The associations identified in the study may not indicate causal relationships, particularly from the secondary use of existing COPE data. 2) COVID-19 status was based on self-reporting in lieu of PCR-tested results, which were limited at the early stages of the pandemic. 3) COVID-19 infection is highly related to social behaviors, which vary significantly among age groups. Some of the stratification analyses in particular age groups were underpowered. 4) As shopping status is combined with outings, the impact on the commercial built environment is worth further study. 5) COVID-19, anxiety, and stress present interwoven relationships. Therefore, the order of the phenotypes can hardly be determined and are all confounded by socioeconomic status (e.g., employment status, financial difficulties, and other COVID-19 related impacts). This was not included in the current study due to the option for multiple answers rather than the multiple-choice survey in COPE, which might cause power issues and multicollinearity in regression. In conclusion, the study demonstrated that the association of the built environment with a shared component tends to increase COVID-19 transmission and that their dwellers experience increased anxiety and stress levels. It is crucial to improve the quality of the built environment through planning, design, and management, pursuing a more resilient society that is able...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

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  2. Version published to 10.1101/2022.04.05.22273358v1 on medRxiv