Disparities in Exposure and Health Effects of Multiple Environmental Stressors Across the Life Course

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PROJECT SUMMARY The primary objective of our Center is to understand and reduce environmental health disparities (EHDs) by conducting three fully-integrated research projects applying novel methods in epidemiology, exposure science, and cumulative risk assessment, with strong community engagement across the Center. The Center emphasizes multiple health outcomes across the life course with evidence for EHDs (birth outcomes, childhood growth rates, and cardiovascular mortality), in Massachusetts and within two low-income majority-minority communities (Chelsea and Dorchester). The influence of housing and the neighborhood environment on multiple exposures and health outcomes are emphasized throughout the Center. Within Project 3, we use novel geospatial data and simulation techniques to provide an extensive and highly resolved set of chemical and non-chemical stressor exposures, including spatially-resolved air pollution and temperature data generated in Project 1. In this supplement, we will leverage our Project 3 geospatial database of numerous social, housing, demographic, and environmental exposures across Massachusetts to evaluate racial/ethnic disparities in COVID-19 cases, hospitalizations, and deaths. Our geospatial vulnerability data will be linked with individual-level COVID-19 data with address-level geocodes and daily temporal resolution, provided by the Massachusetts Department of Public Health. We will identify vulnerability factors associated with disparities in incidence and severity of COVID-19 infection across cities and towns in Massachusetts, modeling predictors of case incidence per 10,000 persons and hospitalizations per 10,000 persons by city/town over time. We will also apply novel methods to characterize spatiotemporal clustering, allowing us to determine differences in spatiotemporal patterns of COVID-19 spread within and between cities/towns, including as a function of individual characteristics. Finally, we will examine differences in city/town-specific policies, implementation of state policy, and resident perception of public health recommendations, to determine if observed patterns can be explained in part by between-city differences. With these analyses we will identify COVID-19 hot spots in Massachusetts and how cases spread within and between communities, including the hardest-hit majority-minority communities, and we will determine the vulnerability factors that best explain these exposure and health outcome disparities.