Disentangling Race And Place: Association Of Chronic Fine Particulate Matter Exposure, Racial Segregation And Pulmonary Health

Abstract

Background: Despite calls for increased recognition of non-chemical stressors into new models of cumulative risk assessment, limited empirical data exists. Previous studies have found increased exposure to environmental pollutants and higher rates of respiratory disease and illness in minority populations across the United States. However, few have explored differences in chronic low-level exposures to air pollution in the highly segregated Upper-Midwest, an area with lower overall air pollution exposures but where significant racial and ethnic health disparities exist. Methods: Hierarchical Bayesian estimates of 12 km grid fine particular matter (PM2.5) data from the US EPA and data from the Survey of the Health of Wisconsin (SHOW) were used to examine the association between exposure to low-level chronic air pollution and lung function (measured as percent predicted FEV1). Correlations between neighborhood socio-demographics, race and air pollution exposures were examined first. Then linear spline and multivariate regression were used to examine associations and stratification to evaluate how associations are modified by race and place. Results: A total of 1394 participants from the 2008-2013 SHOW residing in their homes greater than five years were included. Overall, mean PM2.5 exposures were higher in blacks (12.00, CI 11.90, 12.04) than whites (10.00, CI 9.94, 10.06). Overall, for exposures greater than 10 ug/m3 a ten unit increase in PM2.5 was associated with -.42 (CI -.66, -.25) drop in FEV1 and -.85 (CI -1.10,-.60) in predicted FEV1. Among non-whites, associations were significantly greater for both FEV1 (-.74 CI -1.32, -.16) and predicted FEV1 (-1.17 CI -1.68, -.66). Discussion: After careful adjustment race does have an influence on both exposure and lung function in this study population, at levels below current health based standards. Findings suggest regulatory opportunities for reducing environmental health disparities exist.