RESUMO
A private-academic partnership built the Vaccine Equity Planner (VEP) to help decision-makers improve geographic access to COVID-19 vaccinations across the United States by identifying vaccine deserts and facilities that could fill those deserts. The VEP presented complex, updated data in an intuitive form during a rapidly changing pandemic situation. The persistence of vaccine deserts in every state as COVID-19 booster recommendations develop suggests that vaccine delivery can be improved. Underresourced public health systems benefit from tools providing real-time, accurate, actionable data. (Am J Public Health. 2023;113(4):363-367. https://doi.org/10.2105/AJPH.2022.307198).
Assuntos
Vacinas contra COVID-19 , COVID-19 , Humanos , Saúde Pública , COVID-19/prevenção & controle , Assistência Médica , PandemiasRESUMO
BACKGROUND: A large body of evidence connects access to greenspace with substantial benefits to physical and mental health. In urban settings where access to greenspace can be limited, park access and use have been associated with higher levels of physical activity, improved physical health, and lower levels of markers of mental distress. Despite the potential health benefits of urban parks, little is known about how park usage varies across locations (between or within cities) or over time. METHODS: We estimated park usage among urban residents (identified as residents of urban census tracts) in 498 US cities from 2019 to 2021 from aggregated and anonymised opted-in smartphone location history data. We used descriptive statistics to quantify differences in park usage over time, between cities, and across census tracts within cities, and used generalised linear models to estimate the associations between park usage and census tract level descriptors. FINDINGS: In spring (March 1 to May 31) 2019, 18·9% of urban residents visited a park at least once per week, with average use higher in northwest and southwest USA, and lowest in the southeast. Park usage varied substantially both within and between cities; was unequally distributed across census tract-level markers of race, ethnicity, income, and social vulnerability; and was only moderately correlated with established markers of census tract greenspace. In spring 2019, a doubling of walking time to parks was associated with a 10·1% (95% CI 5·6-14·3) lower average weekly park usage, adjusting for city and social vulnerability index. The median decline in park usage from spring 2019 to spring 2020 was 38·0% (IQR 28·4-46·5), coincident with the onset of physical distancing policies across much of the country. We estimated that the COVID-19-related decline in park usage was more pronounced for those living further from a park and those living in areas of higher social vulnerability. INTERPRETATION: These estimates provide novel insights into the patterns and correlates of park use and could enable new studies of the health benefits of urban greenspace. In addition, the availability of an empirical park usage metric that varies over time could be a useful tool for assessing the effectiveness of policies intended to increase such activities. FUNDING: Google.