Disparities In Quality Research Articles

Sleep Health Patterns in Romania: Insights from a Nationwide Cross-Sectional Online Survey

Background: Sleep is one of the most essential processes for sustaining cognitive, emotional, and physical health across all age groups. Insomnia or inadequate sleep significantly impacts health and poses economic burdens due to increased healthcare costs and reduced productivity. Objectives and Methods: This study aimed to investigate sleep quality in the Romanian active population using an online survey incorporating the Pittsburgh Sleep Quality Index (PSQI). Conducted over four months in 2023, the survey gathered 2243 complete responses from urban and rural residents over the age of 18. Results: The results highlight gender and urban–rural disparities in sleep quality, revealing that females and urban residents experienced poorer sleep compared to their counterparts. Additionally, sleep quality was found to significantly worsen with age, with elders (56+ years) reporting the highest PSQI scores, indicating greater sleep difficulties compared to middle-aged adults and youngsters. A high prevalence of sleep disturbances, daytime dysfunctions, and sleep medication use was reported. Common pre-sleep activities included using electronic devices and watching TV, while fewer participants engaged in reading books or consuming alcohol and caffeine. Additionally, participants’ bedding preferences were documented. Conclusions: Our study highlights the influence of various factors on sleep quality and emphasizes the need for targeted public health interventions to improve sleep health in Romania.

The HEROES (HEalth woRkfOrcE to meet health challengeS) Joint Action

Abstract Background The HEROES (HEalth woRkfOrcE to meet health challengeS) Joint Action aims to advance health workforce planning across the EU, addressing the pressing need for a resilient, sustainable, and accessible health service systems. Given the evident strain on health systems demonstrated during the COVID-19 pandemic, this initiative seeks to address the critical need for strategic HWF planning. Building on previous projects, HEROES will foster the capacity of EU states in workforce planning, preparing the health systems to meet future challenges. Methods The study adopts a collaborative framework involving 19 EU countries, segmented into clusters based on health system characteristics. A stepwise approach (‘AS IS,’ ‘TO BE,’ ‘TO DO’) characterizes the methodology, incorporating extensive data collection, stakeholder engagement, and scenario forecasting. Country-level information on HWF Data and Planning will be compared both across countries in clusters and across clusters. Results Initial findings indicate significant disparities in health workforce data quality, availability, and planning methodologies among the states. Identified methodologies also involve real-world data applications and predictive analytics to refine health workforce planning. Efforts are underway to define an Advanced Minimum Dataset (AMDS) to synchronize health workforce data and define planning tools across the clusters, as country-level AS IS reports have been finalized and cross-country comparisons are ongoing. Conclusions Collaborative, data-driven health workforce planning can significantly enhance health system resilience and responsiveness. Recommended public health actions include enhancing HWF data integration, forecasting capabilities, and stakeholder participation, with the aim of shaping national health policies and practices. The public health impact is profound, as it allows to improve health service delivery and workforce adaptability in response to dynamic health demands. Key messages • The HEROES Joint Action advances EU health workforce planning, with the aim of enhancing the resilience and responsiveness of health systems. • Strategic data-driven approaches in health workforce planning are pivotal for resilient, accessible and sustainable healthcare systems.

Telemedicine as a tool for bridging geographical inequity: insights in geospatial interactions from a study on chronic heart failure patients

IntroductionChronic heart failure patients experience large disparities in quality of and access to treatment, with rural populations receiving lower levels of care. Telemonitoring of patients is increasingly being used as an important tool for improving patient management and care and might reduce geographical inequities in healthcare.MethodsWe investigate the presence and magnitude of a geospatial interaction effect on the health benefit of a supplementary telemedicine intervention, by analyzing the relationship between distance to regular place of treatment and the benefit of telemedicine in a secondary analysis of data from a previously conducted RCT. We use change in EQ5D health status, SF-36 Physical component score and SF-36 Mental component score as the outcomes. In the unadjusted analysis, intervention group and distance group and the interaction term are included as the independent variables, in the adjusted analysis, multiple socioeconomic and health related variables are included to account for potential confounders.ResultsWe find evidence of a significant interaction between the effects of telemedicine and long distance to treatment for change in EQ5D health status (unadjusted: p = 0.016, adjusted p = 0.009) and unadjusted but not adjusted mental component score (unadjusted: p = 0.013, adjusted p = 0.0728), for the change in physical component score the interaction term was not significant (unadjusted: p = 0.118, adjusted p = 0.092).ConclusionIn our study we find that supplementary telemedicine is likely to reduce the health access inequities associated with geographical distance for chronic heart failure patients. However, our sample size was modest and further research is needed to confirm these findings.

Quality of Life of Vietnam People through Education and Health Index

The quality of life of the population is a measure of the sustainable development of the country, in which education and health care play an important role. In Vietnam, education and health care have made important strides in improving people's lives, helping to improve the level of education and public health care. The education system is expanding with many good improvement policies, while the health sector is also developing strongly through strengthening facilities and wider access to health services. However, there are still many challenges, quality disparities between regions and overload in hospitals... The article focuses on studying the current status of education, health care, and its impact on the quality of life of the population.

Air quality disparities and respiratory health risks in critically polluted and relatively non-polluted areas: a prospective child health study.

Air pollution, a significant global health concern, notably impacts human well-being. Children, owing to their distinctive physiology and behavior, are particularly susceptible to its adverse effects. This prospective study examines air quality variations and respiratory risks in children residing in critically polluted areas (CPA) compared to relatively non-polluted areas (NPA), utilizing a prospective design to understand the impacts of air pollution on children's respiratory health, including measures like relative risk (RR) and attributable risk (AR). This prospective study tracked 739 students of 5th- 7th grade residing in CPA and NPA for one year, and measured the ambient and indoor air quality levels in both these areas. Throughout the study, based on the observed respiratory symptoms new episodes of upper and lower respiratory tract illnesses were recorded for each child on a weekly basis. Incidence rate, RR and AR for both the illnesses were compared. Statistical analysis was performed with SPSS 26.0. The study observes higher concentration for particulate matter and gaseous pollutants at CPA in comparison to NPA. Children living in CPA exhibited a notably greater weekly occurrence of both upper and lower respiratory tract illnesses compared to those in NPA, with RR of 1.26 (95% CI: 1.16-1.37) and 1.74 (95% CI: 1.34-2.27), respectively. The AR associated with air pollution for upper and lower respiratory tract illnesses among CPA students was found to be 20.7% and 42.7%, respectively. This research underscores the pressing need to address air pollution in critically polluted areas and its profound effects on children's respiratory health. Public health interventions, such as reducing emissions from industries and creating green spaces, should be prioritized. Furthermore, early respiratory health screening in schools within polluted areas could aid in the timely diagnosis and management of respiratory issues in children.

Multi-View Soft Attention-Based Model for the Classification of Lung Cancer-Associated Disabilities.

Background: The detection of lung nodules at their early stages may significantly enhance the survival rate and prevent progression to severe disability caused by advanced lung cancer, but it often requires manual and laborious efforts for radiologists, with limited success. To alleviate it, we propose a Multi-View Soft Attention-Based Convolutional Neural Network (MVSA-CNN) model for multi-class lung nodular classifications in three stages (benign, primary, and metastatic). Methods: Initially, patches from each nodule are extracted into three different views, each fed to our model to classify the malignancy. A dataset, namely the Lung Image Database Consortium Image Database Resource Initiative (LIDC-IDRI), is used for training and testing. The 10-fold cross-validation approach was used on the database to assess the model's performance. Results: The experimental results suggest that MVSA-CNN outperforms other competing methods with 97.10% accuracy, 96.31% sensitivity, and 97.45% specificity. Conclusions: We hope the highly predictive performance of MVSA-CNN in lung nodule classification from lung Computed Tomography (CT) scans may facilitate more reliable diagnosis, thereby improving outcomes for individuals with disabilities who may experience disparities in healthcare access and quality.

County-level racial bias is associated with worse care for white and especially black older US adults: a cross-sectional observational study

ObjectiveTo assess the association of county-level bias about black and white people with patient experience, influenza immunisation, and quality of clinical care for black and white older US adults (age...

Challenges and opportunities in pediatric residency: an analysis of the increasing number of residents in Italy.

Pediatric residency in Italy has undergone significant changes in recent years, with a notable increase in the number of pediatric residents. Exploring the implications of this increase, highlighting disparities in training opportunities, and discussing the broader socio-economic impacts on pediatric healthcare, represent a crucial consideration for the healthcare system in the future. The Italian National Association of Pediatric Residents ("Osservatorio Nazionale Specializzandi in Pediatria", ONSP) conducted an extensive survey among pediatric residents to assess the current state of pediatric residency. Key findings indicate that 50% of respondents believe the number of residents is excessive for the available training opportunities, leading to concerns about the quality of education and hands-on experience. Despite the increased number of residents, the workload has increased, but up to one-third of residents feel that the autonomy provided by their programs is insufficient. Significant disparities in training quality were found across different regions, with notable shortages in neonatology and pediatric emergency departments. Research opportunities are also limited, with only 17% of residents finding the time allocated to research satisfactory, especially in central and southern Italy. The increase in pediatric residents presents both challenges and opportunities. Addressing these challenges through strategic reforms, such as implementing standardized national curricula, investing in training resources and mobility programs, and enhancing research opportunities, is crucial for the future of pediatric residency in Italy. Ensuring high-quality training for all residents is an ethical and practical obligation that will significantly impact pediatric healthcare.

Broadband Services Quality of Experience on Public Higher Educational Institution Users: A Research Direction

Internet access is crucial in facilitating effective learning and communication. However, disparities in internet quality persist, especially within Public Higher Educational Institutions (PHEIs). Despite efforts by broadband providers to enhance services, complaints regarding quality persist among students and staff. Thus, this research aims to investigate users' Quality of Experience (QoE) with broadband services in PHEI campuses, focusing on coverage, service quality, reliability, and usability. Additionally, it seeks to identify user preferences and usage patterns, correlate broadband quality with user satisfaction, and propose improvements. A comprehensive methodology integrating qualitative and quantitative approaches, including surveys, and interviews is proposed. The implications of this research extend to regulatory and policy actions, including infrastructure improvement, ensuring quality of service, supporting online learning, and encouraging research and innovation in broadband technologies. This study aims to inform stakeholders and contribute to enhancing broadband access and quality in PHEIs, ultimately improving educational outcomes and experiences.

Association between Socio-Demographic Factors and Quality of Life for Patients with Knee Osteoarthritis in Baaquba City

Background: Osteoarthritis is a degenerative joint condition causing joint dysfunction, discomfort, and limited range of motion; it may be affected by poor quality of life. Aim of the study: The study aims to investigate the association between socio-demographic factors and the quality of life for patients with knee osteoarthritis in Baquba City. Methods: A cross-sectional study at Baquba Teaching Hospital in Iraq analyzed 374 adult patients with kneeosteoarthritis, 18 or older, both sexes, and verbal consent. The researchers used a self-structured questionnaire and Dhafar M. et al.'s socioeconomic scale to assess patients' socio-demographic characteristics. Data collection involved direct interviews, and statistical significance was determined using IBM SPSS-29 software. Results: The study found that the majority of participants, particularly women, were married and lived in urban areas, with 53.2% having a family history of knee OA. A study shows that many patients with knee osteoarthritis have poor quality of life, with only 0.5% rating it as excellent. The study reveals significant differences in quality of life scores across age groups, with the 50-59 group reporting fair quality of life (40.0%) and the 60- 69 group (34.0%). The study found significant disparities in quality of life scores across different occupations, with housewives and retired individuals experiencing higher rates, while employees, married couples, and illiterate individuals reported fair quality of life. Conclusion: The study reveals that knee osteoarthritis patients are mostly overweight or obese, with retired individuals and housewives being the largest risk group. They often lack literacy and experience a low quality of life.

Variation in Opioid Agonist Dosing in Clinical Trials by Race and Ethnicity

Racial and ethnic disparities in access to treatment and quality of treatment for opioid use disorder (OUD) have been identified in usual care settings. In contrast, disparities in treatment quality within clinical trials are relatively unexamined. To estimate racial and ethnic differences in the dose of opioid agonist treatment for OUD in the first 4 weeks of treatment in clinical trials. This cohort study performed analysis of the methadone and buprenorphine treatment arms of 3 trials conducted by the National Institute on Drug Abuse Clinical Trials Network between May 2006, and January 31, 2017, at multiple Clinical Trials Network sites across the US. Trial participants who were randomized to and initiated buprenorphine or methadone treatment and who identified as Hispanic, non-Hispanic Black, or non-Hispanic White were included in the present study. Data were analyzed from November 1, 2023, to August 5, 2024. Combined race and ethnicity as self-classified by the patient at trial enrollment. The maximum daily dose of buprenorphine or methadone received in each week for the first 4 weeks of treatment. The mean dose and the percentage of patients receiving a higher dose (buprenorphine ≥16 mg and methadone ≥60 mg) were compared across race and ethnicity groups. A total of 1748 patients (1263 who initiated buprenorphine and 485 who initiated methadone treatment) were included in the analysis (1168 [66.8%] male; median age, 33 [IQR, 26-45] years). Of these, 138 patients (7.9%) identified as Black, 273 (15.6%) as Hispanic, and 1337 (76.5%) as White. In week 4, Black patients received buprenorphine doses 2.5 (95% CI -4.6 to -0.5) mg lower and methadone doses 16.7 (95% CI, -30.7 to -2.7) mg lower compared with White patients, after standardizing by age and sex. In week 4, the percentage of patients receiving a higher dose of medication (buprenorphine ≥16 mg; methadone ≥60 mg) was 16.9 (95% CI, -31.9 to -1.9) points lower for Black patients compared with White patients. Hispanic and White patients received similar buprenorphine doses; Hispanic patients received lower methadone doses than White patients. In this cohort study of data from 3 clinical trials, White patients generally received higher doses of medication than Black patients. Future research is needed to understand the mechanisms of and interventions to reduce disparities in OUD treatment quality and how such disparities impact generalizability of trial results.

Sleep as a Predictor of Health-Related Quality of Life among Economically Disadvantaged Black Older Adults.

Sleep disturbances may partially account for the health-related quality of life (HRQoL) disparities experienced by Black older adults when compared to non-Hispanic White (NHW) adults. The present study examined the role of self-reported sleep duration and the belief that one is not getting enough sleep on physical and mental HRQoL among Black older adults. Participants were 281 community-dwelling, economically disadvantaged Black older adults between 60 and 97 years of age (Mean=69.01, SD=6.97) who lived in a large city in the Southeastern United States. The present study uses baseline data from a larger intervention study aimed at promoting social connection and food security among older adults. For this study (and as part of the larger intervention), participants completed an assessment battery that included (1) a demographic data and health questionnaire that included self-reported sleep duration and a belief that one is not getting enough sleep questions; (2) the CDC (Centers for Disease Control and Prevention) Health-Related Quality of Life-14 Healthy Days Core Module; and (3) the World Health Organization Quality of Life-Brief Form. Descriptive results show that most participants slept less than 7 hours and felt like they did not get enough sleep. Results from 2 hierarchical regressions also showed that believing one is not getting enough sleep predicts lower self-reported mental and physical HRQoL. While sleep deprivation has a serious impact on quality of life for Black older adults, sleep disturbances in this population are understudied. Interventions to improve sleep duration and quality among Black older adults may help reduce disparities in quality of life between Black older adults and NHW adults.

Chinese American Pain Experience Project (CAPE): Perceptions, Expectations, and Attitudes on Pain Management among Chinese American Postoperative Patients.

Chinese Americans are one of the fastest growing racial and ethnic groups and represent the largest subgroup of the Asian American population in the US and in New York City (NYC) where they number 573,528 in 2021. Despite their numbers, current pain perceptions, expectations, and attitudes of Chinese Americans remains poorly understood, especially as related to postoperative pain. A better understanding of pain experience among Chinese American patients is needed to inform strategies on improving pain management satisfaction. A total of 27 Chinese American postoperative patients from a NYC health system were recruited for face-to-face surveys and interviews with a trained bilingual and bicultural Community Health Worker. Questions from the Survey on Disparities in Quality of Healthcare and Kleinman's Explanatory Model of Illness were integrated into the survey and topic guide. Topics of discussion included satisfaction with healthcare and pain management during hospital stay and health beliefs and practices. More than half of participants experienced language challenges that made it difficult to communicate with healthcare staff. In general, high levels of satisfaction with pain management were reported; however, participants reported feeling less comfortable asking healthcare teams questions. Common themes across interviews included: (1) pain was an expected outcome of the procedure and was thus perceived as tolerable; (2) the wish to not be a burden to others; (3) concerns about side effects of pain medications; and (4) a cultural and language mismatch between healthcare teams and patients on words being used to elicit pain and discomfort. Our project findings can inform pain management strategies and tools to serve the Chinese American patient population.

Association between Unmet Social Need and Ambulatory Quality of Care for U.S. Children

ObjectivesChildren who experience socioeconomic adversity often have worse health; however, less is known about their quality of care. We sought to evaluate the association between parent/caregiver-reported socioeconomic adversity and quality of pediatric primary, acute, and chronic ambulatory care on a national level. MethodsThis was a retrospective cohort study of 5,368 representative U.S. children (1-17 years) in the 2021 Medical Expenditure Panel Survey. Socioeconomic adversity was defined as parent/caregiver-reported food, housing, transportation, or utility insecurity in the past 12 months. Outcomes included 10 quality measures of primary, acute, and chronic care, and experience of care measured through parent/caregiver survey. We described variation in socioeconomic adversity and used multivariable regression to examine associations with quality outcomes. ResultsOne-third of parent/caregivers reported socioeconomic adversity. Food insecurity (23.6%) was most common followed by utility (19.5%), housing (15.0%), and transportation (4.7%) insecurity. Black (53.2%) and Hispanic (46.9%) parent/caregivers experienced the highest rates of socioeconomic adversity. Children with socioeconomic adversity received lower quality of care for 4 quality measures, including more frequent ED visits (Odds Ratio (OR)=1.69 [95% Confidence Interval (CI):1.28-2.23]), less favorable asthma medication ratio (OR=0.04 [95%CI:0.01-0.31]), and less frequent well child (OR=0.73 [95%CI:0.59-0.90]) and dental care (OR=0.76 [95%CI:0.63-0.94], p <.05 for all). There were no statistically significant differences in experience of care. ConclusionsSocioeconomic adversity is common among U.S children with disproportionate impact on Black and Hispanic families. There are significant disparities in pediatric primary, acute, and chronic care quality, based on parent/caregiver-reported socioeconomic adversity, highlighting the need for systems-level interventions.

Sleep quality disparities in different pregnancy trimesters in low- and middle-income countries: a systematic review and meta-analysis

IntroductionSleep is a crucial determinant of maternal and fetal health, significantly impacting the well-being of both the mother and her developing fetus. Poor sleep quality, characterized by difficulties in falling asleep or staying asleep, can cause poor pregnancy outcome. Conversely, studies came with inconsistent result in the prevalence of poor sleep quality in different trimester of pregnancy. Therefore, this systematic review and meta-analysis study aimed to compare the prevalence of poor sleep quality in different trimesters.MethodA systematic review and meta-analysis were done on published studies. Electronic data base search was done from PubMed, Hinari, Medline and Google Scholar. Data were extracted with Excel and the analysis were done using STATA version 17. Publication bias was assessed both graphically and statistically. I-square test was used to identify heterogeneity.ResultIn this meta-analysis, 38 studies that measured poor sleep quality using the Pittsburg Sleep Quality Index (PSQI ≥ 5) were included. The pooled prevalence of poor sleep quality was identified as 37.46% (95% CI: 29.26, 45.67) in the first trimester, 47.62% (95% CI: 42.23, 53.02) in the second trimester, and 60.05% (95% CI: 51.32, 68.78) in the third trimester.ConclusionThis study identified a significant discrepancy in the prevalence of poor sleep quality, which increases as gestational age advances. Therefore, this discrepancy should be addressed, and additional support should be provided to pregnant women to help them achieve adequate sleep, especially as gestational age advances.

Ride-hailing technology mitigates effects of driver racial discrimination, but effects of residential segregation persist

We assess racial disparities in the service quality of app-based ride-hailing services, like Uber and Lyft, by simulating their operations in the city of Chicago using empirical data. To generate driver cancellation rate disparities consistent with controlled experiments (up to twice as large for Black riders as for White riders), we estimate that more than 3% of drivers discriminate by race. We find that the capabilities of ride-hailing technology to rapidly rematch after a cancellation and prioritize long-waiting customers heavily mitigates the effects of driver discrimination on rider wait times, reducing average discrimination-induced disparities to less than 1 min-an order of magnitude less than traditional taxis. However, our results suggest that even in the absence of direct driver discrimination, Black riders in Chicago wait about 50% longer, on average, than White riders because of historically informed geographic residential patterns. We estimate that if Black riders in the city had the same wait times as White riders, the collective travel time saved would be worth $4.2 million to $7.0 million per year.

Perceptual Disparities in Transportation Accessibility, Neighborhood Quality, and Satisfaction across Metro, Urban, and Rural Areas

Perceptual Disparities in Transportation Accessibility, Neighborhood Quality, and Satisfaction across Metro, Urban, and Rural Areas

Remote Sensing Evaluation and Monitoring of Spatial and Temporal Changes in Ecological Environmental Quality in Coal Mining-Intensive Cities

In coal-dependent urban economies, the dichotomy between resource exploitation and ecological conservation presents a pronounced challenge. Traditional remote sensing ecological assessments often overlook the interplay between mining activities and urban environmental dynamics. To address this gap, researchers developed an innovative Resource-Based City Ecological Index (RCEI), anchored in a Pressure–State–Response (PSR) framework and synthesized from six discrete ecological indicators. Utilizing geodetic remote sensing data, the RCEI facilitated a comprehensive spatiotemporal analysis of Jincheng City’s ecological quality from 1990 to 2022. The findings corroborated the RCEI’s efficacy in providing a nuanced portrayal of the ecological state within mining regions. (1) Jincheng City’s ecological quality predominantly sustained a mudhopper-tier status, exhibiting an overarching trend of amelioration throughout the study period. (2) Disparities in ecological landscape quality were pronounced at the county level, with Moran’s Index exceeding 0.9, signifying a clustered ecological quality pattern. High–high (H–H) zones were prevalent in areas of elevated altitude and dense vegetation, whereas low–low (L–L) zones were prevalent in urban and mining sectors. (3) Further, a buffer zone analysis of two coal mines, differing in their mining chronology, geographical positioning, and operational status, elucidated the ecological impact exerted over a 32-year trajectory. These insights furnish a robust scientific and technical foundation for resource-centric cities to fortify ecological safeguarding and to advance sustainable development stratagems.

Racial and Ethnic Disparities in Dietary Intake and Quality Among United States Veterans

BackgroundDietary quality plays an important role in disease development and prognosis, and diet is also a key contributor to disparities in many chronic diseases and health conditions. ObjectivesThis study aimed to assess racial and ethnic disparities experienced by veterans; we examined food intake and dietary quality across different racial and ethnic groups of United States veterans. MethodsThe study included 420,730 males and females aged 19–107 y (91.2% males) enrolled in the Veterans Affairs Million Veteran Program with plausible dietary intake measured by food frequency questionnaire. Dietary quality was evaluated with dietary approaches to stop hypertension (DASH) score. Dietary intakes of various race and ethnicity groups were standardized to the age distribution of non-Hispanic White participants, separately for males and females. Differences across race and ethnicity groups were compared using general linear regression models after adjustment for socioeconomic and lifestyle factors as well as military service. ResultsCompared to non-Hispanic White males, non-Hispanic Black males had a relatively lower DASH score, higher red and processed meats, higher sugar-sweetened beverages (SSBs), and lower low-fat dairy intakes. Non-Hispanic Asian males had a relatively higher DASH score as compared to non-Hispanic White males with relatively higher intakes of fruits and vegetables and relatively lower intakes of sodium, red meat and SSBs. Age-standardized DASH scores of Hispanic males and “Other” race/ethnicity groups were not statistically different from non-Hispanic White males. Similar race and ethnicity dietary patterns were found in females, although not all reached a statistically significant level. ConclusionsA modest difference in overall dietary quality (i.e., DASH score) was observed, but unique differences in food preferences across the different racial/ethnic groups were identified. Findings from our study may provide insight for the potential development of specific interventions to help address nutritional disparities experienced among veterans.

Air Quality Geospatial Analysis in Vulnerable Areas. Case Study of Valencia (Spain).

The escalating concern over poor air quality, particularly nitrogen dioxide (NO2), poses a critical public health challenge, especially for vulnerable populations, such as children, older adults, and those with chronic diseases. This study aimed to analyze air quality in areas with vulnerable populations through a geospatial analysis of NO2 concentration measured by the passive dosimetry method in 2022. The results reveal high vulnerability caused by areas with over-centralized facilities and high concentrations of nitrogen dioxide, often coinciding with busy avenues. The study emphasizes the urgent need to address air quality disparities, providing crucial insights for public decision-makers to allocate resources effectively and reduce environmental inequalities in the city, ultimately safeguarding the health of at-risk communities.