Abstract
Background: Environmental hazards often accumulate in areas of low socioeconomic status. However, little is known about individual patterns of environmental exposure. We linked individual data from an ongoing cohort study with contextual exposure data to elucidate spatiotemporal patterns of exposure in an urban population. Methods: We used data from the population-based prospective Heinz Nixdorf Recall Study on 4814 randomly selected residents, aged 45-75 years at baseline, from the highly urbanized Ruhr Area in West-Germany. Residential history for a 10 year period before baseline examination was obtained from city registries for 3320 participants. We collected small-scale contextual social risk factors, including area-level unemployment rate, mean income, residential stability, population density, and percentage of elderly. Environmental physico-chemical exposures of interest were long-term exposure to fine particulate matter, proximity to traffic and chronic traffic noise. Individual socioeconomic and lifestyle factors were assessed repeatedly. Using bivariate and multivariate hierarchical analyses, we investigated spatiotemporal exposure variations in the study area and their associations with individual socio-economic status. Results: During the 10 years before baseline, participants with low education or with low income spent more time in exposed neighborhoods than participants with high education or high income. For example, participants in the lowest and highest income group lived 15.3% and 10.0%, respectively, of the 10 years before baseline at residences with high traffic noise exposure (>65 dB(A) 24h mean). Every year of high residential noise exposure was associated with a 3% (95% CI 0-5%) higher prevalence of hypertension. Conclusions: The accumulation of individual and contextual risk factors over time and across residential histories poses a risk for the development of chronic disease.
Published Version
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