Abstract
The hypotheses we intended to contrast were, first, that the most deprived neighborhoods in Barcelona, Spain, present high exposure to environmental hazards (differential exposure) and, secondly, that the health effects of this greater exposure were higher in the most deprived neighborhoods (differential susceptibility). The population studied corresponded to the individuals residing in the neighborhoods of Barcelona in the period 2007–2014. We specified the association between the relative risk of death and environmental hazards and socioeconomic indicators by means of spatio-temporal ecological regressions, formulated as a generalized linear mixed model with Poisson responses. There was a differential exposure (higher in more deprived neighborhoods) in almost all the air pollutants considered, when taken individually. The exposure was higher in the most affluent in the cases of environmental noise. Nevertheless, for both men and women, the risk of dying due to environmental hazards in a very affluent neighborhood is about 30% lower than in a very depressed neighborhood. The effect of environmental hazards was more harmful to the residents of Barcelona’s most deprived neighborhoods. This increased susceptibility cannot be attributed to a single problem but rather to a set of environmental hazards that, overall, a neighborhood may present.
Highlights
Today, there is abundant evidence that health inequalities exist [1]
There is significant asymmetry in the distribution of all of them, and some of the variables have an interquartile range which is extremely large when compared to the median, and, albeit to a much lesser extent, socioeconomic variables
The dispersion of the environmental hazard variables was much lower than the rest of explanatory variables, where only benzene had an interquartile range near 100% of its median, while SO2, NO2, and carbon monoxide (CO) were near 50% of their medians and the rest had much smaller dispersions
Summary
There is abundant evidence that health inequalities exist [1]. Despite this having already been established in the seminal Black Report [2], it was the Acheson Report (Independent Inquiry intoInequalities in Health) that firmly concluded that there is scientific evidence of health inequalities having a socioeconomic explanation [3]. There is abundant evidence that health inequalities exist [1] Despite this having already been established in the seminal Black Report [2], it was the Acheson Report Twenty years later, those relationships have mostly been proven [1,4,5,6], with a not insignificant proportion of them being caused by environmental problems [7]. These factors are usually, not uniquely, linked to socioeconomic conditions [7,8,9,10,11,12]. Some authors have pioneered environmental justice studies in Europe, drawing on frameworks and methods developed in the context of environmental justice in the United States [15,16,17,18,19]
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