Air Pollution, Cardiovascular Outcomes, and Social Disadvantage

Abstract

Background Social factors may enhance health effects of air pollution, yet empirical support is inconsistent. The interaction of social and environmental factors may only be evident with long-term exposures and outcomes that reflect long-term disease development Methods We used cardiac magnetic resonance imaging data from the Multi-Ethnic Study of Atherosclerosis to assess left-ventricular mass index (LVMI) and left-ventricular ejection fraction (LVEF). We assigned residential concentrations of fine particulate matter (PM2.5), oxides of nitrogen (NOx), and nitrogen dioxide (NO2) in the year 2000 to each participant in 2000 using prediction models. We examined modifying roles of four measures of adversity: race/ethnicity, racial/ethnic residential segregation, and socioeconomic status (SES) and psychosocial adversity as composite indices on the association between air pollution and LVMI or LVEF. Results Compared to whites, blacks showed a stronger adjusted association between air pollution and LVMI. For example, for each 5 μg/m3 greater PM2.5 level, whites showed a 1.0 g/m2 greater LVMI (95%CI: -1.3, 3.1) while blacks showed an additional 4.0 g/m2 greater LVMI (95%CI: 0.3, 8.2). Results were similar for NOx and NO2 with regard to black race and LVMI. However, we found no evidence of a modifying role of other social factors or ethnic groups. Furthermore, we found no evidence of a modifying role for any social factors or racial/ethnic groups on the association between air pollution and LVEF. Conclusions Our results suggest that racial group membership may modify the association between air pollution and cardiovascular disease.

Air Pollution and Noncommunicable Diseases

“…60,61 It may also enhance the effects of particulate pollution on BP. 62 The association between air pollution and cancer risk has been shown to be greater in neighborhoods with higher levels of ethnic minority segregation, an indicator that may capture the cumulative impact of multiple adverse social and psychosocial exposures. 63 Impoverished individuals, especially ethnic minorities, are more likely to live in segregated neighborhoods that are near sources of pollution and busy roadways.…”

Multi-Contextual Segregation and Environmental Justice Research: Toward Fine-Scale Spatiotemporal Approaches

“…The statistic is calculated by the following equation: , where is the spatial weight value between areas i and j (which indicates their spatial relationship); is the attribute value of area j ; and n is the total number of areas.). Similarly, a more recent study used the same spatial statistical method to investigate the joint effects of racial segregation and air pollution on cardiovascular outcomes [ 66 ]. However, some scholars have been skeptical about whether spatial autocorrelation and local spatial statistical approaches can improve the measurement of segregation levels [ 35 , 67 ], arguing that a high degree of positive spatial autocorrelation does not always indicate a high level of segregation.…”

Neighborhood Perceptions and Cumulative Impacts of Low Level Chronic Exposure to Fine Particular Matter (PM2.5) on Cardiopulmonary Health

“…Population exposures to ambient air pollutants such as PM 2.5 are also often highly correlated with adverse neighborhood built environment features, but research examining their joint effects are limited [ 1 , 9 , 10 , 11 , 12 , 13 , 14 ]. Neighborhood features of the built and social environment have been shown to independently contribute to adverse cardiopulmonary health even after adjusting for individual behaviors and socioeconomic position (SEP), however, mechanisms underlying these associations are not well understood [ 4 , 15 , 16 , 17 , 18 ]. Experiences of everyday living within neighborhoods may play an essential role in shaping how neighborhood built environment contributes to persistent cardiopulmonary health disparities by SEP [ 3 , 6 , 19 ].…”