Racial/ethnic disparities in PM2.5-attributable cardiovascular mortality burden in the United States

Yiqun Ma, Emma Zang, Ijeoma Opara, Yuan Lu, Harlan M. Krumholz and Kai Chen ()
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Yiqun Ma: Department of Environmental Health Sciences, Yale School of Public Health
Emma Zang: Yale University
Ijeoma Opara: Yale School of Public Health
Yuan Lu: Center for Outcomes Research and Evaluation, Yale New Haven Hospital
Harlan M. Krumholz: Center for Outcomes Research and Evaluation, Yale New Haven Hospital
Kai Chen: Department of Environmental Health Sciences, Yale School of Public Health

Nature Human Behaviour, 2023, vol. 7, issue 12, 2074-2083

Abstract: Abstract Average ambient fine particulate matter (PM2.5) concentrations have decreased in the US in recent years, but the health benefits of this improvement among different racial/ethnic groups are unknown. We estimate the associations between long-term exposure to ambient PM2.5 and cause-specific cardiovascular disease (CVD) mortality rate and assess the PM2.5-attributable CVD deaths by race/ethnicity across 3,103 US counties during 2001–2016 (n = 595,776 county-months). A 1 µg m−3 increase in PM2.5 concentration was associated with increases of 7.16 (95% confidence interval (CI): 3.81, 10.51) CVD deaths per 1,000,000 Black people per month, significantly higher than the estimates for non-Hispanic white people (1.76 (95% CI: 1.37, 2.15); difference in coefficients: 5.40 (95% CI: 2.03, 8.77), P = 0.001). No significant difference in this association was observed between Hispanic (2.66 (95% CI: −0.03, 5.35)) and non-Hispanic white people (difference in coefficients: 0.90 (95% CI: −1.81, 3.61), P = 0.523). From 2001 to 2016, the absolute disparity in PM2.5-attributable CVD mortality burden was reduced by 44.04% between non-Hispanic Black and white people and by 2.61% between Hispanic and non-Hispanic white people. However, in 2016, the burden remained 3.47 times higher for non-Hispanic Black people and 0.45 times higher for Hispanic people than for non-Hispanic white people. We call for policies that aim to reduce both exposure and vulnerability to PM2.5 for racial/ethnic minorities.

Date: 2023
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DOI: 10.1038/s41562-023-01694-7

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