The One-Two-Three Punch: Exposure, Susceptibility, and Disease Burden among U.S. Populations of Color

Seltenrich, Nate

doi:10.1289/ehp10904

Cited by 5 publications

(8 citation statements)

References 7 publications

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“…In addition, racism-intersecting and mutually reinforcing societal systems and institutions which foster and perpetuate racial discrimination and structure opportunities inequitably-in the U.S., contribute to higher levels of stress and likelihood of living in neighborhoods that are impacted by environmental racism, resulting in both higher CVD burden and vulnerability to air pollution. 22,41 In our study, the relative burden of PM2.5-attributable CVD mortality in non-Hispanic Black people was found to be over 3 times greater than the burden in non-Hispanic White people. The disparity in this annual burden between Black and White people (58.6 additional CVD deaths per 1,000,000 people) is of the same magnitude as the contribution of alcohol use to CVD mortality in the whole U.S. population in 2019 (55.3 CVD deaths per 1,000,000 people), according to the estimates from the GBD study.…”

Section: Discussionmentioning

confidence: 47%

“…Multiple studies consistently demonstrated that people of color are typically exposed to higher levels of air pollution than non-Hispanic White people in the U.S, [9][10][11][12] which is a pervasive and persistent consequence of redlining, inequitable siting of emission sources (e.g., highways and industrial facilities), and other policies and practices. 40,41 Benefited by the improvement of air quality in recent decades in the U.S., the overall PM2.5-attributable CVD mortality burden was greatly reduced. Among racial/ethnic groups, this burden decreased most among non-Hispanic Black people, thus narrowed the racial/ethnic disparity.…”

Section: Discussionmentioning

confidence: 99%

“…A cohort study based on all Medicare beneficiaries reported that Black people had a higher estimated risk of all-cause mortality in association with PM 2.5 exposure than the general population. 27 This higher vulnerability of Black people can be explained by residential segregation and other downstream social determinants of structural racism in the U.S. 40, 41 For example, Black people in the U.S. tend to have limited access to high-quality healthcare, education, credit, and other socioeconomic opportunities due to systemic racism. In addition, racism—intersecting and mutually reinforcing societal systems and institutions which foster and perpetuate racial discrimination and structure opportunities inequitably—in the U.S., contribute to higher levels of stress and likelihood of living in neighborhoods that are impacted by environmental racism, resulting in both higher CVD burden and vulnerability to air pollution.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, racism—intersecting and mutually reinforcing societal systems and institutions which foster and perpetuate racial discrimination and structure opportunities inequitably—in the U.S., contribute to higher levels of stress and likelihood of living in neighborhoods that are impacted by environmental racism, resulting in both higher CVD burden and vulnerability to air pollution. 22, 41…”

Section: Discussionmentioning

confidence: 99%

“…Multiple studies consistently demonstrated that people of color are typically exposed to higher levels of air pollution than non-Hispanic White people in the U.S, 9-12 which is a pervasive and persistent consequence of redlining, inequitable siting of emission sources (e.g., highways and industrial facilities), and other policies and practices. 40, 41…”

Section: Discussionmentioning

confidence: 99%

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Racial/ethnic disparities in cardiovascular disease mortality attributable to long-term PM_2.5exposure in the United States from 2001 to 2016

Ma¹,

Zang

Opara

et al. 2022

Preprint

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Background: The average concentration of fine particulate matter (PM2.5) has decreased in the U.S. in recent years. However, the health benefits of this improvement among different racial/ethnic groups are not known. This study aimed to estimate the associations between long-term exposure to ambient PM2.5 and cause-specific cardiovascular disease (CVD) mortality rate and assess the PM2.5-attributable CVD deaths in non-Hispanic White, non-Hispanic Black, and Hispanic people across all counties in the contiguous U.S. from 2001 to 2016. Methods: Using nationwide CVD mortality data for all ages obtained from National Center for Health Statistics, this study applied interactive fixed effects models to estimate the associations between 12-month moving average of PM2.5 concentrations and monthly age-adjusted CVD mortality rates by race/ethnicity, controlling for both measured and unmeasured spatiotemporal confounders. Mortality from major types of CVD (ischemic heart disease [IHD], myocardial infarction [MI], stroke, hypertensive disease, and hypertensive heart disease) was also studied. We then calculated the burden of PM2.5-attributable CVD deaths in different race/ethnicity groups and examined the magnitude of racial/ethnic disparity and its changes over time. Results: A total of 13,289,147 CVD deaths were included in the study. Each 1-μg/m3 increase in 12-month moving average of PM2.5 concentration was associated with increases of 7.16 (95% confidence interval [CI]: 3.81, 10.51) CVD deaths per 1,000,000 Black people per month, significantly higher than the estimates for non-Hispanic White people (P value: 0.002). The higher vulnerability in non-Hispanic Black people was also observed for mortality from IHD, MI, and stroke. Long-term PM2.5 exposure contributed to approximately 75.47 (95% CI: 40.14, 110.80) CVD deaths per 1,000,000 non-Hispanic Black people annually, over 3 times higher than the estimated rate in non-Hispanic White people (16.89, 95% CI:13.17, 20.62). From 2001 to 2016, the difference in attributable CVD mortality rate between Black and White people reduced by 44.04% (from 75.80 to 42.42 per 1,000,000 people), but the burden in Black people was still over 3 times higher compared to White people. Conclusions: Non-Hispanic Black people have the highest PM2.5-attributable CVD mortality burden. Although the racial/ethnic disparity in this burden was narrowed over time, the gap between racial/ethnic minorities and non-Hispanic White people remains substantial.

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Section: Discussionmentioning

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Racial/ethnic disparities in cardiovascular disease mortality attributable to long-term PM_2.5exposure in the United States from 2001 to 2016

Ma¹,

Zang

Opara

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

Racial/ethnic disparities in PM2.5-attributable cardiovascular mortality burden in the United States

Ma,

Zang,

Opara

et al. 2023

Nat Hum Behav

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Long-term exposure to wildland fire smoke PM2.5 and mortality in the contiguous United States

Ma¹,

Zang

Liu

et al. 2023

Preprint

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Despite the growing evidence on the health effects of wildfire smoke in the western U.S., the nationwide mortality risk and burden attributable to wildfire smoke fine particles (PM2.5) remain unclear. This study aims to investigate the association between wildfire smoke PM2.5 and mortality from all causes, cardiovascular diseases, respiratory diseases, and mental disorders, and calculate the corresponding attributable mortality burden in all 3,108 counties in the contiguous U.S., from 2006 to 2016. Monthly county-level mortality counts were collected from National Center for Health Statistics. Wildfire smoke PM2.5 concentration was derived from a 10×10 km2 resolution spatiotemporal model. Controlling for non-smoke PM2.5, air temperature, and unmeasured spatial and temporal confounders, we found that a 1 μg/m3 increase in smoke PM2.5 was significantly associated with an increase of 0.14% (95% confidence interval [CI]: 0.11%, 0.17%) in all-cause mortality, 0.13% (95% CI: 0.08%, 0.18%) in cardiovascular mortality, 0.16% (95% CI: 0.07%, 0.25%) in respiratory mortality, and 1.08% (95% CI: 0.93%, 1.23%) in mental disorder mortality. Smoke PM2.5 contributed to approximately 1,141 all-cause deaths/year (95% CI: 893, 1,388) in the contiguous U.S., of which over three-fourths were from cardiovascular, respiratory, and mental causes. We found a higher vulnerability among males than females, people aged 0 to 64 years than those ≥65 years, and racial/ethnic minorities than non-Hispanic White people. Mild droughts were found to enhance the association between smoke PM2.5 and mortality. Our results indicate that wildfire smoke PM2.5 harms both physical and mental health, which suggests the need for more effective wildfire mitigation strategies and public health responses in the U.S.

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The One-Two-Three Punch: Exposure, Susceptibility, and Disease Burden among U.S. Populations of Color

Cited by 5 publications

References 7 publications

Racial/ethnic disparities in cardiovascular disease mortality attributable to long-term PM_2.5exposure in the United States from 2001 to 2016

Racial/ethnic disparities in cardiovascular disease mortality attributable to long-term PM_2.5exposure in the United States from 2001 to 2016

Racial/ethnic disparities in PM2.5-attributable cardiovascular mortality burden in the United States

Long-term exposure to wildland fire smoke PM2.5 and mortality in the contiguous United States

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The One-Two-Three Punch: Exposure, Susceptibility, and Disease Burden among U.S. Populations of Color

Cited by 5 publications

References 7 publications

Racial/ethnic disparities in cardiovascular disease mortality attributable to long-term PM2.5exposure in the United States from 2001 to 2016

Racial/ethnic disparities in cardiovascular disease mortality attributable to long-term PM2.5exposure in the United States from 2001 to 2016

Racial/ethnic disparities in PM2.5-attributable cardiovascular mortality burden in the United States

Long-term exposure to wildland fire smoke PM2.5 and mortality in the contiguous United States

Contact Info

Product

Resources

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Racial/ethnic disparities in cardiovascular disease mortality attributable to long-term PM_2.5exposure in the United States from 2001 to 2016

Racial/ethnic disparities in cardiovascular disease mortality attributable to long-term PM_2.5exposure in the United States from 2001 to 2016