Chronic household air pollution and exposure patterns among Himalayan nomads.

BACKGROUND: Household air pollution (HAP) is a major risk factor of non-communicable diseases, causing millions of premature deaths each year in developing nations. Populations living at high altitudes are particularly vulnerable to HAP and associated health outcomes. OBJECTIVES: This study aims to explore the relationships between activity patterns, HAP, and an HAP biomarker among 100 Himalayan nomadic households during both cooking and heating-only periods. METHODS: Household CO was monitored in 100 rural homes in Qinghai, China, at 3500 m on the Himalayan Plateau among Himalayan nomads. Carboxyhemoglobin (COHb) was used as a biomarker to assess exposure among 100 male and 100 female heads of household. Linear mixed-effects models were used to explore the relationship between COHb and activity patterns. RESULTS: Cooking periods were associated with 7 times higher household CO concentrations compared with heating periods (94 ± 56 ppm and 13 ± 11 ppm, respectively). Over the three-day biomarker-monitoring period in each house, 99% of subjects had at least one COHb measurement exceeding the WHO safety level of 2%. Cooking was associated with a 32% increase in COHb (p < 0.001). IMPACT STATEMENT: This study on household air pollution (HAP) in high-altitude regions provides important insights into the exposure patterns of nomadic households in Qinghai, China. The study found that cooking is the primary factor influencing acute carbon monoxide (CO) exposure among women, while heating alone is sufficient to elevate CO exposure above WHO guidelines. The results suggest that cooking-only interventions have the potential to reduce HAP exposure among women, but solutions for both cooking and heating may be required to reduce COHb to below WHO guidelines. This study's findings may inform future interventions for fuel and stove selection to reduce HAP and exposure among other populations.

Greenspace related to bipolar disorder in Taiwan: Quantitative benefits of saving DALY loss and increasing income.

Scientific evidence reported that surrounding greenspace could promote better mental health. Considering bipolar disorder as the health outcome, this study aimed to investigate the association between greenspace and bipolar disorder in Taiwan and quantified the benefits of greenspace on bipolar disorder adjusted for the international greenspace availability standard. By examining datasets across 348 townships, two quantitative measures (i.e., disability-adjusted life year loss and income) were used to represent the benefits. The incidence rate of bipolar disorder was obtained from Taiwan's National Health Insurance Research Database. Normalized different vegetation index (NDVI) was measured as a proxy for the greenspace availability. A generalized additive mixed model coupled with a sensitivity test were applied to evaluate the statistical association. The prevented fraction for the population (PFP) was then applied to develop a scenario for quantifying benefit. The result showed a significant negative association between greenspace and bipolar disorder in Taiwan. Compared to low greenspace, areas with medium and high greenspace may reduce the bipolar risk by 21% (RR = 0.79; 95% CI = 0.76-0.83) and 51% (RR = 0.49; 95% CI = 0.45-0.53). Calculating benefits, we found that the development of a scenario by increasing greenspace adjusted for availability indicator in township categorized as low greenspace could save in DALY loss due to bipolar disorder up to10.97% and increase in income up to 11.04% from the current situation. Lastly, this was the first study in Asia-Pacific to apply a customized greenspace increment scenario to quantify the benefits to a particular health burden such as bipolar disorder.

In situ psycho-cognitive assessments support self-determined urban green exercise time.

Prescribed nature walks frequently yield improvements to mood and cognition as observed in experimental studies. Research that uses real life settings such as self-determined time exercising outdoors for restorative health benefits may more accurately elicit effects than time-specified study protocols. This study examined in situ psycho-cognitive outcomes of routine walks in urban greenspace to test the concept that self-set exposure duration and not context alone is related to magnitude of psycho-cognitive benefit. Pre-post measurements taken on a diverse participant pool of individuals walking in urban parks and recruited on random days over a two-week period found significant associations between outdoor activity duration and cognitive and mood improvements. Greater outdoor walking duration linearly predicted stronger processing speeds but non-linearly in tests of other cognitive domains. Results of fixed effects model for mean mood change following green exercise show outdoor walking influenced mood change at highest levels of significance, even after accounting for individual level variability in duration. Mood improved for all durations of outdoor walking under a random effects model with high significance. Untethering fixed intervals of outdoor exercise from formal study design revealed briefer but more frequent nature engagement aligned with nature affinity. The influence of unmeasured factors, e.g., nature affinity or restorative conditioning, for prescriptive durations of urban green exercise merits further investigation toward designing wellbeing interventions directed at specific urban populations.

Childhood pneumonia in Beijing: Associations and interactions among selected demographic and environmental factors.

Among infectious diseases, pneumonia is the greatest cause of mortality in children less than 5 years old. Approximately 27% of Beijing's 3-8 year-old children have had pneumonia at least once. The sole reservoir of pneumonia pathogens is the human nasopharynx. We investigated associations and interactions among two kinds of environmental risk factors: i) airborne pathogens, namely closed bedroom window and shared bedroom and ii) pollutants, namely traffic pollution and environmental tobacco smoke (ETS). We evaluated breastfeeding's (BF) protective value against childhood pneumonia. The database consists of responses to a questionnaire in a cross-sectional study. Crude and adjusted Odds Ratios were assessed independently for each risk factor. Combinations of the studied risk factors were analyzed using multivariate logistic regression. Risk factors were evaluated for interactions on the additive scale using the metrics Relative Excess Risk due to Interaction (RERI), Attributable Proportion (AP) and Synergy Index (S). All independent risk factors were significant for children's pneumonia. We also found evidence of possible synergistic interaction between pairs of risk factors that was stronger when one of the risk factors was a closed bedroom window. Remarkably, window opening was associated with reduced risk of pneumonia for children living near heavy traffic pollution. Longer duration BF was more protective than shorter, and exclusive BF was more protective than partial BF against childhood pneumonia. In conclusion, low ventilation (closed bedroom windows), shared bedroom, ETS, and traffic exposure were associated with increased risk of pneumonia. Exclusive BF for more than six months had the greatest protective value against pneumonia.

Implications of disparities in social and built environment antecedents to adult nature engagement.

Antecedent factors which influence adult engagement with nature are underexplored given the human health benefits strongly associated with nature exposure. Formative pathways and impediments to nature contact merit understanding as they may contribute to later-life health disparities. We probed experiential pathways and attitudes toward nature engagement among adults purposefully sampled across U.S. regions, age, race/ethnicity, and urbanicity through semi-structured focus group discussions. The research aims were to explore entryways and barriers to experiencing nature and learn how natured and built environments compete in influencing human-nature relationships. Sessions were recorded, transcribed, and analyzed following Braun and Clarke's phases of thematic analysis. Qualitative content analysis of discussions identified three principal themes: 1) formative influences promoting adult nature engagement (i.e., persons/organizations and places of origin), 2) detractors from nature engagement (i.e., perceptual, material, and physical barriers), and 3) role of current setting (i.e., natural and built environments) shaping nature-seeking relationships. We found experiential factors that included early life exposures outdoors, personal mentorship, and organizational affiliation to be highly influential in socializing individuals to nature and in soldering attachment to nature which manifests into adulthood. In contrast, changing demographics and childhood, inequity, social dynamics, metropolitan growth, urban renewal explained alienation from nature. These findings emphasize the importance of efforts to expand opportunities for nature contact, especially for youth living in economically challenged urban areas, which go beyond increasing greenspace to encompass mentoring partnerships for gaining skills and comfort outdoors and redesign of safe natured spaces within cities for hands-on learning and discovery.

Examining the Benefits of Greenness on Reducing Suicide Mortality Rate: A Global Ecological Study.

Objective: This study applied an ecological-based analysis aimed to evaluate on a global scale the association between greenness exposure and suicide mortality. Methods: Suicide mortality data provided by the Institute for Health Metrics and Evaluation and the Normalized Difference Vegetation Index (NDVI) were employed. The generalized additive mixed model was applied to evaluate with an adjustment of covariates the association between greenness and suicide mortality. Sensitivity tests and positive-negative controls also were used to examine less overt insights. Subgroup analyses were then conducted to investigate the effects of greenness on suicide mortality among various conditions. Results: The main finding of this study indicates a negative association between greenness exposure and suicide mortality, as greenness significantly decreases the risk of suicide mortality per interquartile unit increment of NDVI (relative risk = 0.69, 95%CI: 0.59-0.81). Further, sensitivity analyses confirmed the robustness of the findings. Subgroup analyses also showed a significant negative association between greenness and suicide mortality for various stratified factors, such as sex, various income levels, urbanization levels, etc. Conclusions: Greenness exposure may contribute to a reduction in suicide mortality. It is recommended that policymakers and communities increase environmental greenness in order to mitigate the global health burden of suicide.

Exploring the Potential Relationship Between Global Greenness and DALY Loss Due to Depressive Disorders.

Objective: Prior studies have shown that greenness can reduce the burden of depressive disorders. However, most were focused on local-scale analyses while limited evaluated globally. We aimed to investigate the association between greenness and the burden of depressive disorders using data from 183 countries worldwide. Methods: We used the normalized difference vegetation index (NDVI) to estimate greenness. Country-level disability-adjusted life year (DALY) loss due to depressive disorders was used to represent depressive disorder burdens. A generalized linear mixed model was applied to assess the relationship between greenness and depressive disorders after controlling for covariates. Stratified analyses were conducted to determine the effects of greenness across several socio-demographic levels. Results: The findings showed a significant negative association between greenness and the health burden of depressive disorders with a coefficient of -0.196 (95% CI: -0.356, -0.035) in the DALY changes per interquartile unit increment of NDVI. The stratified analyses suggested beneficial effects of greenness on depressive disorders across sex, various age groups especially for those aged <49 years, with low-income and/or those living in highly urbanized countries. Conclusions: Our study noted that greenness exposure was significant negative association with the burden of depressive disorders. The findings should be viewed as recommendations for relevant authorities in supporting environmental greenness enhancement to reduce the mental burdens.

Home is Where the Pipeline Ends: Characterization of Volatile Organic Compounds Present in Natural Gas at the Point of the Residential End User.

The presence of volatile organic compounds (VOCs) in unprocessed natural gas (NG) is well documented; however, the degree to which VOCs are present in NG at the point of end use is largely uncharacterized. We collected 234 whole NG samples across 69 unique residential locations across the Greater Boston metropolitan area, Massachusetts. NG samples were measured for methane (CH4), ethane (C2H6), and nonmethane VOC (NMVOC) content (including tentatively identified compounds) using commercially available USEPA analytical methods. Results revealed 296 unique NMVOC constituents in end use NG, of which 21 (or approximately 7%) were designated as hazardous air pollutants. Benzene (bootstrapped mean = 164 ppbv; SD = 16; 95% CI: 134-196) was detected in 95% of samples along with hexane (98% detection), toluene (94%), heptane (94%), and cyclohexane (89%), contributing to a mean total concentration of NMVOCs in distribution-grade NG of 6.0 ppmv (95% CI: 5.5-6.6). While total VOCs exhibited significant spatial variability, over twice as much temporal variability was observed, with a wintertime NG benzene concentration nearly eight-fold greater than summertime. By using previous NG leakage data, we estimated that 120-356 kg/yr of annual NG benzene emissions throughout Greater Boston are not currently accounted for in emissions inventories, along with an unaccounted-for indoor portion. NG-odorant content (tert-butyl mercaptan and isopropyl mercaptan) was used to estimate that a mean NG-CH4 concentration of 21.3 ppmv (95% CI: 16.7-25.9) could persist undetected in ambient air given known odor detection thresholds. This implies that indoor NG leakage may be an underappreciated source of both CH4 and associated VOCs.

Tradeoffs between ventilation, air mixing, and passenger density for the airborne transmission risk in airport transportation vehicles.

Airport transportation vehicles, such as buses, aerotrains, and shuttles, provide important passenger transfer services in airports. This study quantitatively investigated COVID-19 aerosol infection risk and identified acceptable operational conditions, such as passenger occupancy rates and duration of rides, given the performance of vehicle ventilation. The greatest risk to the largest number of passengers is from an index case whose exhaled breath would take the longest time to exit the vehicle. The study identified such a case based on ventilation patterns, and it tracked the spread of viral aerosols (5 µm) by using the Wells-Riley equation to predict aerosol infection risk distribution. These distributions allowed a definition of an imperfect mixing degree (δ) as the ratio of actual risk and the calculated risk under a perfect mixing condition, and further derived regression equations to predict δ in the far-field (FF) and near-field (NF) of each passenger. These results revealed an order of magnitude higher aerosol infection risk in NF than in FF. For example, with a ventilation rate of 58 ACH (air changes per hour) and a 45% occupancy rate, unmasked passengers should stay up to 15 min in the bus and 35 min in the shuttle to limit infection risk in NF within 10%. These also indicate that masking is an important and effective risk reduction measure in transportation vehicles, especially important in NF. Overall, the analysis of imperfect air mixing allows direct comparison of risks in different transportation vehicles and a structured approach to development of policy recommendations.

Exposure to Unconventional Oil and Gas Development and All-cause Mortality in Medicare Beneficiaries.

Little is known about whether exposure to unconventional oil and gas development is associated with higher mortality risks in the elderly and whether related air pollutants are exposure pathways. We studied a cohort of 15,198,496 Medicare beneficiaries (136,215,059 person-years) in all major U.S. unconventional exploration regions from 2001 to 2015. We gathered data from records of more than 2.5 million oil and gas wells. For each beneficiary's ZIP code of residence and year in the cohort, we calculated a proximity-based and a downwind-based pollutant exposure. We analyzed the data using two methods: Cox proportional hazards model and Difference-in-Differences. We found evidence of statistically significant higher mortality risk associated with living in proximity to and downwind of unconventional oil and gas wells. Our results suggest that primary air pollutants sourced from unconventional oil and gas exploration can be a major exposure pathway with adverse health effects in the elderly.

Metals dust in workers' homes and potential for take home in the Greater Boston area: Pilot study.

Toxic metals such as lead, cadmium, arsenic, are present at construction worksites. From work, metals can easily, unintentionally be transported to homes of workers, contaminating living spaces and affecting others including children, known as "take-home exposure." Focus has been given to minimizing lead take-home exposure but less is known about other metals. This pilot study aims to better understand the sources and predictors of metals in the home primarily of construction workers (n = 21), but also explore other workers potentially exposed [janitorial (n = 4) and auto repair (n = 2) jobs]. Greater Boston workers were recruited in 2018-2019 through collaboration with community-based organizations and worker unions serving low-income/immigrant workers. During a home visit, a dust vacuum sample was collected, a worker questionnaire was administered, and home observations were performed to determine factors that could affect home metals concentration. Thirty elements were analyzed in the dust via inductively coupled plasma coupled to atomic emission and mass spectrometry. We performed univariable and multivariable models, potential predictive factors, and multivariable mixed-effect regression analyses combining metals. Arsenic, chromium, copper, lead, manganese, nickel, and tin, commonly found in construction, were higher in construction workers' home dust compared to other workers, although not statistically significant. Sociodemographic/work/home-related variables affected home metals dust concentrations. Various work-related factors were associated with higher metal dust levels, for example: no work locker vs. locker (nickel ratio of means or ROM = 4.2, p < 0.05); mixing vs. no mixing work/personal items (nickel ROM = 1.6, p < 0.05); dusty vs. no dusty at work (copper ROM = 3.1, p < 0.05); not washing vs. washing hands after work (manganese ROM = 1.4, p < 0.05); not changing vs. changing clothes after work (cadmium ROM = 6.9, p < 0.05; copper ROM = 3.6, p < 0.05). Mixed effect regression confirmed statistical significance, which suggests a likelihood of metal mixtures carrying a "take-home" potential. Lead home interventions should evaluate other metals exposure reduction.

Influence of living in the same home on biomonitored levels of consumer product chemicals.

BACKGROUND: Individuals living in the same home may share exposures from direct contact with sources or indirectly through contamination of the home environment. OBJECTIVE: We investigated the influence of sharing a home on urine levels of ten phenolic chemicals present in some consumer products. METHODS: We used data from Silent Spring Institute's Detox Me Action Kit (DMAK), a crowdsourced biomonitoring program in the US. Of the 726 DMAK participants, 185 lived in the same home with one or more other DMAK participants (n = 137 pairs, up to six participants in a home). The concentration distributions included values below the detection limit so we used statistical methods that account for left-censored data, including non-parametric correlation estimation and hierarchical Bayesian regression models. RESULTS: Concentrations were significantly positively correlated between pair-members sharing a home for nine of the ten chemicals. Concentrations of 2,5-dichlorophenol were the most strongly correlated between pair-members (tau = 0.46), followed by benzophenone-3 (tau = 0.31) and bisphenol A (tau = 0.21). The relative contribution of personal product use reported product use of other household members (up to 5 others), and the residual contribution from a shared household, including exposures not asked about, varied by chemical. Paraben concentrations were largely influenced by personal behaviors whereas dichlorophenol and bisphenol concentrations were largely influenced by shared home exposures not related to reported behaviors. SIGNIFICANCE: Measuring the influence of personal and household practices on biomonitoring exposures helps pinpoint major sources of exposure and highlights chemical-specific intervention strategies to reduce them.

Indoor humidity levels and associations with reported symptoms in office buildings.

Moderate indoor relative humidity (RH) levels (i.e., 40%-60%) may minimize transmission and viability of some viruses, maximize human immune function, and minimize health risks from mold, yet uncertainties exist about typical RH levels in offices globally and about the potential independent impacts of RH levels on workers' health. To examine this, we leveraged one year of indoor RH measurements (which study participants could view in real time) in 43 office buildings in China, India, Mexico, Thailand, the United Kingdom, and the United States, and corresponding self-report symptom data from 227 office workers in a subset of 32 buildings. In the buildings in this study, 42% of measurements during 9:00 - 17:00 on weekdays were less than 40% RH and 7% exceeded 60% RH. Indoor RH levels tended to be lower in less tropical regions, in winter months, when outdoor RH or temperature was low, and late in the workday. Furthermore, we also found statistically significant evidence that higher indoor RH levels across the range of 14%-70% RH were associated with lower odds of reporting dryness or irritation of the throat and skin among females and unusual fatigue among males in models adjusted for indoor temperature, country, and day of year.

Health benefits of decreases in on-road transportation emissions in the United States from 2008 to 2017.

Decades of air pollution regulation have yielded enormous benefits in the United States, but vehicle emissions remain a climate and public health issue. Studies have quantified the vehicle-related fine particulate matter (PM2.5)-attributable mortality but lack the combination of proper counterfactual scenarios, latest epidemiological evidence, and detailed spatial resolution; all needed to assess the benefits of recent emission reductions. We use this combination to assess PM2.5-attributable health benefits and also assess the climate benefits of on-road emission reductions between 2008 and 2017. We estimate total benefits of $270 (190 to 480) billion in 2017. Vehicle-related PM2.5-attributable deaths decreased from 27,700 in 2008 to 19,800 in 2017; however, had per-mile emission factors remained at 2008 levels, 48,200 deaths would have occurred in 2017. The 74% increase from 27,700 to 48,200 PM2.5-attributable deaths with the same emission factors is due to lower baseline PM2.5 concentrations (+26%), more vehicle miles and fleet composition changes (+22%), higher baseline mortality (+13%), and interactions among these (+12%). Climate benefits were small (3 to 19% of the total). The percent reductions in emissions and PM2.5-attributable deaths were similar despite an opportunity to achieve disproportionately large health benefits by reducing high-impact emissions of passenger light-duty vehicles in urban areas. Increasingly large vehicles and an aging population, increasing mortality, suggest large health benefits in urban areas require more stringent policies. Local policies can be effective because high-impact primary PM2.5 and NH3 emissions disperse little outside metropolitan areas. Complementary national-level policies for NOx are merited because of its substantial impacts-with little spatial variability-and dispersion across states and metropolitan areas.

The Effects of Ventilation and Filtration on Indoor PM2.5 in Office Buildings in Four Countries.

Fine particulate matter (PM2.5) is an airborne pollutant associated with negative acute and chronic human health outcomes. Although the majority of PM2.5 research has focused on outdoor exposures, people spend the majority of their time indoors, where PM2.5 of outdoor origin can penetrate. In this work, we measured indoor PM2.5 continuously for one year in 37 urban commercial offices with mechanical or mixed-mode ventilation in China, India, the United Kingdom, and the United States. We found that indoor PM2.5 concentrations were generally higher when and where outdoor PM2.5 was elevated. In India and China, mean workday indoor PM2.5 levels exceeded the World Health Organization's 24-hour exposure guideline of 25 µg/m3 about 17% and 27% of the time, respectively. Our statistical models found evidence that the operation of mechanical ventilation systems could mitigate the intrusion of outdoor PM2.5: during standard work hours, a 10 µg/m3 increase in outdoor PM2.5 was associated with 19.9% increase in the expected concentration of indoor PM2.5 (p<0.0001), compared to a larger 23.4% increase during non-work hours (p<0.0001). Finally, our models found that using filters with ratings of MERV 13-14 or MERV 15+ was associated with a 30.9% (95% CI: -55.0%, +6.2%) or 39.4% (95% CI: -62.0%, -3.4%) reduction of indoor PM2.5, respectively, compared to filters with lower MERV 7-12 ratings. Our results demonstrate the potential efficacy of mechanical ventilation with efficient filtration as a public health strategy to protect workers from PM2.5 exposure, particularly where outdoor levels of PM2.5 are elevated.

The risks of warm nights and wet days in the context of climate change: assessing road safety outcomes in Boston, USA and Santo Domingo, Dominican Republic.

BACKGROUND: There remains a dearth of cross-city comparisons on the impact of climate change through extreme temperature and precipitation events on road safety. We examined trends in traffic fatalities, injuries and property damage associated with high temperatures and heavy rains in Boston (USA) and Santo Domingo (Dominican Republic). METHODS: Official publicly available data on daily traffic outcomes and weather conditions during the warm season (May to September) were used for Boston (2002-2015) and Santo Domingo (2013-2017). Daily maximum temperatures and mean precipitations for each city were considered for classifying hot days, warm days, and warm nights, and wet, very wet, and extremely wet days. Time-series analyses were used to assess the relationship between temperature and precipitation and daily traffic outcomes, using a quasi-Poisson regression. RESULTS: In Santo Domingo, the presence of a warm night increased traffic fatalities with a rate ratio (RR) of 1.31 (95% CI [confidence interval]: 1.00,1.71). In Boston, precipitation factors (particularly, extremely wet days) were associated with increments in traffic injuries (RR 1.25, 95% CI: 1.18, 1.32) and property damages (RR 1.42, 95% CI: 1.33, 1.51). CONCLUSION: During the warm season, mixed associations between weather conditions and traffic outcomes were found across Santo Domingo and Boston. In Boston, increases in heavy precipitation events were associated with higher traffic injuries and property damage. As climate change-related heavy precipitation events are projected to increase in the USA, the associations found in this study should be of interest for road safety planning in a rapidly changing environment.

Spatial patterns of lower respiratory tract infections and their association with fine particulate matter.

This study aimed to identify the spatial patterns of lower respiratory tract infections (LRIs) and their association with fine particulate matter (PM2.5). The disability-adjusted life year (DALY) database was used to represent the burden each country experiences as a result of LRIs. PM2.5 data obtained from the Atmosphere Composition Analysis Group was assessed as the source for main exposure. Global Moran's I and Getis-Ord Gi* were applied to identify the spatial patterns and for hotspots analysis of LRIs. A generalized linear mixed model was coupled with a sensitivity test after controlling for covariates to estimate the association between LRIs and PM2.5. Subgroup analyses were performed to determine whether LRIs and PM2.5 are correlated for various ages and geographic regions. A significant spatial auto-correlated pattern was identified for global LRIs with Moran's Index 0.79, and the hotspots of LRIs were clustered in 35 African and 4 Eastern Mediterranean countries. A consistent significant positive association between LRIs and PM2.5 with a coefficient of 0.21 (95% CI 0.06-0.36) was identified. Furthermore, subgroup analysis revealed a significant effect of PM2.5 on LRI for children (0-14 years) and the elderly (≥ 70 years), and this effect was confirmed to be significant in all regions except for those comprised of Eastern Mediterranean countries.

The Relationship between Nature Deprivation and Individual Wellbeing across Urban Gradients under COVID-19.

Lockdown aiming at slowing COVID-19 transmission has altered nature accessibility patterns, creating quasi-experimental conditions to assess if retracted nature contact and perceived nature deprivation influence physical and emotional wellbeing. We measure through on-line survey methods (n = 529) how pandemic mandates limiting personal movement and outdoor nature access within the United States affect self-assessed nature exposure, perceived nature deprivation, and subsequent flourishing as measured by the Harvard Flourishing Index. Results indicate that perceived nature deprivation strongly associates with local nature contact, time in nature, and access to municipal nature during the pandemic, after controlling for lockdown mandates, job status, household composition, and sociodemographic variables. Our hypothesis is that individuals with strong perceived nature deprivation under COVID-19 leads to diminished wellbeing proved true. Interaction models of flourishing showed positive modification of nature affinity with age and qualitative modification of nature deprivation with race. Our results demonstrate the potential of local nature contact to support individual wellbeing in a background context of emotional distress and social isolation, important in guiding public health policies beyond pandemics.