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      Disparities in Distribution of Particulate Matter Emission Sources by Race and Poverty Status

      , , , ,
      American Journal of Public Health
      American Public Health Association

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          Abstract

          <p class="first" id="d5009412e159"> <i>Objectives.</i> To quantify nationwide disparities in the location of particulate matter (PM)-emitting facilities by the characteristics of the surrounding residential population and to illustrate various spatial scales at which to consider such disparities. </p><p id="d5009412e164"> <i>Methods.</i> We assigned facilities emitting PM in the 2011 National Emissions Inventory to nearby block groups across the 2009 to 2013 American Community Survey population. We calculated the burden from these emissions for racial/ethnic groups and by poverty status. We quantified disparities nationally and for each state and county in the country. </p><p id="d5009412e169"> <i>Results.</i> For PM of 2.5 micrometers in diameter or less, those in poverty had 1.35 times higher burden than did the overall population, and non-Whites had 1.28 times higher burden. Blacks, specifically, had 1.54 times higher burden than did the overall population. These patterns were relatively unaffected by sensitivity analyses, and disparities held not only nationally but within most states and counties as well. </p><p id="d5009412e174"> <i>Conclusions.</i> Disparities in burden from PM-emitting facilities exist at multiple geographic scales. Disparities for Blacks are more pronounced than are disparities on the basis of poverty status. Strictly socioeconomic considerations may be insufficient to reduce PM burdens equitably across populations. </p>

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          State of disparities in cardiovascular health in the United States.

          Reducing health disparities remains a major public health challenge in the United States. Having timely access to current data on disparities is important for policy and program development. Accordingly, we assessed the current magnitude of disparities in cardiovascular disease (CVD) and its risk factors in the United States. Using national surveys, we determined CVD and risk factor prevalence and indexes of morbidity, mortality, and overall quality of life in adults > or =18 years of age by race/ethnicity, sex, education level, socioeconomic status, and geographic location. Disparities were common in all risk factors examined. In men, the highest prevalence of obesity (29.2%) was found in Mexican Americans who had completed a high school education. Black women with or without a high school education had a high prevalence of obesity (47.3%). Hypertension prevalence was high among blacks (39.8%) regardless of sex or educational status. Hypercholesterolemia was high among white and Mexican American men and white women in both groups of educational status. Ischemic heart disease and stroke were inversely related to education, income, and poverty status. Hospitalization was greater in men for total heart disease and acute myocardial infarction but greater in women for congestive heart failure and stroke. Among Medicare enrollees, congestive heart failure hospitalization was higher in blacks, Hispanics, and American Indians/Alaska Natives than among whites, and stroke hospitalization was highest in blacks. Hospitalizations for congestive heart failure and stroke were highest in the southeastern United States. Life expectancy remains higher in women than men and higher in whites than blacks by approximately 5 years. CVD mortality at all ages tended to be highest in blacks. Disparities in CVD and related risk factors remain pervasive. The data presented here can be invaluable for policy development and in the planning, implementation, and evaluation of interventions designed to eliminate health disparities.
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            We tested three competing hypotheses regarding the adult "Hispanic mortality paradox": data artifact, migration, and cultural or social buffering effects. On the basis of a series of parametric hazard models estimated on nine years of mortality follow-up data, our results suggest that the "Hispanic" mortality advantage is a feature found only among foreign-born Mexicans and foreign-born Hispanics other than Cubans or Puerto Ricans. Our analysis suggests that the foreign-born Mexican advantage can be attributed to return migration, or the "salmon-bias" effect. However, we were unable to account for the mortality advantage observed among other foreign-born Hispanics.
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              Association between PM2.5 and all-cause and specific-cause mortality in 27 US communities.

              While fine mode particulate matter (PM(2.5)) forms the basis for regulating particles in the US and other countries, there is a serious paucity of large population-based studies of its acute effect on mortality. To address this issue, we examined the association between PM(2.5) and both all-cause and specific-cause mortality using over 1.3 million deaths in 27 US communities between 1997 and 2002. A two-stage approach was used. First, the association between PM(2.5) and mortality in each community was quantified using a case-crossover design. Second, meta-analysis was used to estimate a summary effect over all 27 communities. Effect modification of age and gender was examined using interaction terms in the case-crossover model, while effect modification of community-specific characteristics including geographic location, annual PM(2.5) concentration above 15 microg/m(3) and central air conditioning prevalence was examined using meta-regression. We observed a 1.21% (95% CI 0.29, 2.14%) increase in all-cause mortality, a 1.78% (95% CI 0.20, 3.36%) increase in respiratory related mortality and a 1.03% (95% CI 0.02, 2.04%) increase in stroke related mortality with a 10 microg/m(3) increase in previous day's PM(2.5). The magnitude of these associations is more than triple that recently reported for PM(10), suggesting that combustion and traffic related particles are more toxic than larger sized particles. Effect modification occurred in all-cause and specific-cause deaths with greater effects in subjects >or=75 years of age. There was suggestive evidence that women may be more susceptible to PM(2.5) effects than men, and that effects were larger in the East than in the West. Increased prevalence of central air conditioning was associated with a decreased effect of PM(2.5). Our findings describe the magnitude of the effect on all-cause and specific-cause mortality, the modifiers of this association, and suggest that PM(2.5) may pose a public health risk even at or below current ambient levels.
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                Author and article information

                Journal
                American Journal of Public Health
                Am J Public Health
                American Public Health Association
                0090-0036
                1541-0048
                February 22 2018
                February 22 2018
                :
                :
                : e1-e6
                Article
                10.2105/AJPH.2017.304297
                5844406
                29470121
                8660a50e-6077-498c-ab74-d285a52ddd29
                © 2018
                History

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