Dataset Information

All-Cause NO₂-Attributable Mortality Burden and Associated Racial and Ethnic Disparities in the United States.

ABSTRACT: Nitrogen dioxide (NO₂) is a regulated pollutant that is associated with numerous health impacts. Recent advances in epidemiology indicate high confidence linking NO₂ exposure with increased mortality, an association that recent studies suggest persists even at concentrations below regulatory thresholds. While large disparities in NO₂ exposure among population subgroups have been reported, U.S. NO₂-attributable mortality rates and their disparities remain unquantified. Here we provide the first estimate of NO₂-attributable all-cause mortality across the contiguous U.S. (CONUS) at the census tract-level. We leverage fine-scale, satellite-informed, land use regression model NO₂ concentrations and census tract-level baseline mortality data to characterize the associated disparities among different racial/ethnic subgroups. Across CONUS, we estimate that the NO₂-attributable all-cause mortality is ∼170,850 (95% confidence interval: 43,970, 251,330) premature deaths yr^-1 with large variability across census tracts and within individual cities. Additionally, we find that higher NO₂ concentrations and underlying susceptibilities for predominately Black communities lead to NO₂-attributable mortality rates that are ∼47% higher compared to CONUS-wide average rates. Our results highlight the substantial U.S. NO₂ mortality burden, particularly in marginalized communities, and motivate adoption of more stringent standards to protect public health.

SUBMITTER: Camilleri SF

PROVIDER: S-EPMC10720462 | biostudies-literature | 2023 Dec

REPOSITORIES: biostudies-literature

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All-Cause NO2-Attributable Mortality Burden and Associated Racial and Ethnic Disparities in the United States.

Camilleri Sara F SF Kerr Gaige Hunter GH Anenberg Susan C SC Horton Daniel E DE

Environmental science & technology letters 20231107 12

Nitrogen dioxide (NO2) is a regulated pollutant that is associated with numerous health impacts. Recent advances in epidemiology indicate high confidence linking NO2 exposure with increased mortality, an association that recent studies suggest persists even at concentrations below regulatory thresholds. While large disparities in NO2 exposure among population subgroups have been reported, U.S. NO2-attributable mortality rates and their disparities rema ...[more]

PMID: 38106529

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Project description:BackgroundAmbient nitrogen dioxide (NO2) and fine particulate matter with aerodynamic diameter ≤2.5μm (PM2.5) threaten public health in the US, and systemic racism has led to modern-day disparities in the distribution and associated health impacts of these pollutants.ObjectivesMany studies on environmental injustices related to ambient air pollution focus only on disparities in pollutant concentrations or provide only an assessment of pollution or health disparities at a snapshot in time. In this study, we compare injustices in NO2- and PM2.5-attributable health burdens, considering NO2-attributable health impacts across the entire US; document changing disparities in these health burdens over time (2010-2019); and evaluate how more stringent air quality standards would reduce disparities in health impacts associated with these pollutants.MethodsThrough a health impact assessment, we quantified census tract-level variations in health outcomes attributable to NO2 and PM2.5 using health impact functions that combine demographic data from the US Census Bureau; two spatially resolved pollutant datasets, which fuse satellite data with physical and statistical models; and epidemiologically derived relative risk estimates and incidence rates from the Global Burden of Disease study.ResultsDespite overall decreases in the public health damages associated with NO2 and PM2.5, racial and ethnic relative disparities in NO2-attributable pediatric asthma and PM2.5-attributable premature mortality have widened in the US during the last decade. Racial relative disparities in PM2.5-attributable premature mortality and NO2-attributable pediatric asthma have increased by 16% and 19%, respectively, between 2010 and 2019. Similarly, ethnic relative disparities in PM2.5-attributable premature mortality have increased by 40% and NO2-attributable pediatric asthma by 10%.DiscussionEnacting and attaining more stringent air quality standards for both pollutants could preferentially benefit the most marginalized and minoritized communities by greatly reducing racial and ethnic relative disparities in pollution-attributable health burdens in the US. Our methods provide a semi-observational approach to track changes in disparities in air pollution and associated health burdens across the US. https://doi.org/10.1289/EHP11900.

Project description:BackgroundAccurate forecasting of cardiovascular disease mortality is crucial to guide policy and programming efforts. Prior forecasts often have not incorporated past trends in rates of reduction in cardiovascular disease mortality. This creates uncertainties about future trends in cardiovascular disease mortality and disparities.Methods and resultsTo forecast US cardiovascular disease mortality and disparities to 2030, we developed a hierarchical bayesian model to determine and incorporate prior age, period, and cohort effects from 1979 to 2012, stratified by age, sex, and race, which we combined with expected demographic shifts to 2030. Data sources included the National Vital Statistics System, Surveillance, Epidemiology, and End Results (SEER) single-year population estimates, and US Bureau of Statistics 2012 national population projections. We projected coronary disease and stroke deaths to 2030, first on the basis of constant age, period, and cohort effects at 2012 values, as is most commonly done (conventional), and then with the use of more rigorous projections incorporating expected trends in age, period, and cohort effects (trend based). We primarily evaluated absolute mortality. The conventional model projected total coronary and stroke deaths by 2030 to increase by ≈18% (67 000 additional coronary deaths per year) and 50% (64 000 additional stroke deaths per year). Conversely, the trend-based model projected that coronary mortality would decrease by 2030 by ≈27% (79 000 fewer deaths per year) and stroke mortality would remain unchanged (200 fewer deaths per year). Health disparities will be improved in stroke deaths but not coronary deaths.ConclusionsAfter prior mortality trends and expected demographic shifts are accounted for, total US coronary deaths are expected to decline, whereas stroke mortality will remain relatively constant. Health disparities in stroke but not coronary deaths will be improved but not eliminated. These age, period, and cohort approaches offer more plausible predictions than conventional estimates.

Dataset Information

All-Cause NO₂-Attributable Mortality Burden and Associated Racial and Ethnic Disparities in the United States.

Publications

All-Cause NO<sub>2</sub>-Attributable Mortality Burden and Associated Racial and Ethnic Disparities in the United States.

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