Green spaces mitigate racial disparity of health: A higher ratio of green spaces indicates a lower racial disparity in SARS-CoV-2 infection rates in the USA

There is striking racial disparity in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rates in the United States. We hypothesize that the disparity is significantly smaller in areas with a higher ratio of green spaces. County level data on the SARS-CoV-2 infection rates of black and white individuals in 135 of the most urbanized counties across the United States were collected. The total population in these counties is 132,350,027, comprising 40.3% of the U.S. population. The ratio of green spaces by land-cover type in each county was extracted from satellite imagery. A hierarchical regression analysis measured cross-sectional associations between racial disparity in infection rates and green spaces, after controlling for socioeconomic, demographic, pre-existing chronic disease, and built-up area factors. We found a higher ratio of green spaces at the county level is significantly associated with a lower racial disparity in infection rates. Four types of green space have significant negative associations with the racial disparity in SARS-CoV-2 infection rates. A theoretical model with five core mechanisms and one circumstantial mechanism is presented to interpret the findings. (author abstract)