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

PROJECT SUMMARY The primary objective of our Center is to understand and reduce environmental healthdisparities (EHDs) by conducting three fully-integrated research projects applying novelmethods in epidemiology, exposure science, and cumulative risk assessment, with strongcommunity engagement across the Center. The Center emphasizes multiple health outcomesacross the life course with evidence for EHDs (birth outcomes, childhood growth rates, andcardiovascular mortality), in Massachusetts and within two low-income majority-minoritycommunities (Chelsea and Dorchester). The influence of housing and the neighborhoodenvironment on multiple exposures and health outcomes are emphasized throughout theCenter. Within Project 3, we use novel geospatial data and simulation techniques to provide anextensive and highly resolved set of chemical and non-chemical stressor exposures, includingspatially-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 inCOVID-19 cases, hospitalizations, and deaths. Our geospatial vulnerability data will be linkedwith individual-level COVID-19 data with address-level geocodes and daily temporal resolution,provided by the Massachusetts Department of Public Health. We will identify vulnerabilityfactors associated with disparities in incidence and severity of COVID-19 infection across citiesand towns in Massachusetts, modeling predictors of case incidence per 10,000 persons andhospitalizations per 10,000 persons by city/town over time. We will also apply novel methods tocharacterize spatiotemporal clustering, allowing us to determine differences in spatiotemporalpatterns of COVID-19 spread within and between cities/towns, including as a function ofindividual characteristics. Finally, we will examine differences in city/town-specific policies,implementation of state policy, and resident perception of public health recommendations, todetermine if observed patterns can be explained in part by between-city differences. With theseanalyses we will identify COVID-19 hot spots in Massachusetts and how cases spread withinand between communities, including the hardest-hit majority-minority communities, and we willdetermine the vulnerability factors that best explain these exposure and health outcomedisparities.