Abstract

Despite longstanding concerns about environmental injustice in Louisiana’s industrialized communities, including the area known as Cancer Alley, there is a lack of environmental health research in this state. This research gap has direct consequences for residents of industrialized neighborhoods because state regulators have cited a lack of evidence for adverse health outcomes when making industrial permitting decisions. We investigated how cancer incidence relates to cancer risk from toxic air pollution, race, poverty, and occupation across Louisiana census tracts, while controlling for parish-level smoking and obesity rates, using linear regression and Akaike information criterion model selection. We used the most recent cancer data from the Louisiana Tumor Registry (2008–2017), estimates of race, poverty, and occupation from the US Census Bureau’s American Community Survey (2011–2015), and estimated cancer risk due to point sources from the US Environmental Protection Agency’s 2005 National Air Toxics Assessment (accounting for cancer latency). Because race and poverty were strongly correlated (r = 0.69, P < 0.0001), we included them in separate, analogous models. Results indicated that higher estimated cancer risk from air toxics was associated with higher cancer incidence through an interaction with poverty or race. Further analysis revealed that the tracts with the highest (i.e. top quartile) proportions of impoverished residents (or Black residents) were driving the association between toxic air pollution and cancer incidence. These findings may be explained by well-established disparities that result in greater exposure/susceptibility to air toxics in Black or impoverished neighborhoods. Regardless, our analysis provides evidence of a statewide link between cancer rates and carcinogenic air pollution in marginalized communities and suggests that toxic air pollution is a contributing factor to Louisiana’s cancer burden. These findings are consistent with the firsthand knowledge of Louisiana residents from predominantly Black, impoverished, and industrialized neighborhoods who have long maintained that their communities are overburdened with cancer.

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