Global Patterns of Environmental Inequities within the Prospective Urban and Rural Epidemiology Study

Abstract

OPS 04: Environmental justice, Room 117, Floor 1, August 27, 2019, 1:30 PM - 3:00 PM Background: Most environmental justice research has been conducted in developed countries, but the largest environmental inequities may exist at a global level and within developing countries. Here, we quantify the associations between diverse environmental exposures and socioeconomic status (SES) within a global cohort study. Methods: We leverage the 167,782 participants from 21 countries of the Prospective Urban and Rural Epidemiology cohort, spanning low to high socioeconomic development. We examined outdoor PM2.5 and NO2 air pollution, household air pollution (HAP), greenness, park access, household water access, perceived local traffic and local pollution, extreme heat days, and change in extreme heat days over a 15-year period. We compared these exposures with individual measures of SES, including education, occupation, a household wealth index, and percent income spent on food. We summarized exposure levels across SES strata and applied multinomial logistic regression models to determine associations between environmental exposures with SES, controlling for country income level, population density and urban/rural status. We examined global and country-specific environmental inequalities stratified by urban and rural communities. Results: Across all communities, we observed the largest SES disparities for HAP, extreme temperature, increase in extreme temperature days, and decreased green space. For example, 41% of individuals with less than a primary school education cooked with solid fuels compared to 6% of individuals with post-secondary education. Individuals with less than primary school education experienced 27 extreme heat days at baseline year compared to 20 for individuals with post-secondary education. Several environmental exposures were also increased with higher SES, including NO2 and perceptions of local traffic and pollution. Substantial differences were observed between urban/rural communities and in country-specific analyses. Conclusion: While environmental risks are associated with SES, the relationships are complex and vary by exposure and local context. It is essential for research and policy to recognize these multifaceted relationships.