Evaluation of the health impacts of the 1990 Clean Air Act Amendments using causal inference and machine learning

Rachel C. Nethery, Fabrizia Mealli, Jason D. Sacks and Francesca Dominici

Journal of the American Statistical Association, 2021, vol. 116, issue 535, 1128-1139

Abstract: We develop a causal inference approach to estimate the number of adverse health events that were prevented due to changes in exposure to multiple pollutants attributable to a large-scale air quality intervention/regulation, with a focus on the 1990 Clean Air Act Amendments (CAAA). We introduce a causal estimand called the Total Events Avoided (TEA) by the regulation, defined as the difference in the number of health events expected under the no-regulation pollution exposures and the number observed with-regulation. We propose matching and machine learning methods that leverage population-level pollution and health data to estimate the TEA. Our approach improves upon traditional methods for regulation health impact analyses by formalizing causal identifying assumptions, utilizing population-level data, minimizing parametric assumptions, and collectively analyzing multiple pollutants. To reduce model-dependence, our approach estimates cumulative health impacts in the subset of regions with projected no-regulation features lying within the support of the observed with-regulation data, thereby providing a conservative but data-driven assessment to complement traditional parametric approaches. We analyze the health impacts of the CAAA in the US Medicare population in the year 2000, and our estimates suggest that large numbers of cardiovascular and dementia-related hospitalizations were avoided due to CAAA-attributable changes in pollution exposure.

Date: 2021
References: Add references at CitEc
Citations: View citations in EconPapers (1)

Downloads: (external link)
http://hdl.handle.net/10.1080/01621459.2020.1803883 (text/html)
Access to full text is restricted to subscribers.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:taf:jnlasa:v:116:y:2021:i:535:p:1128-1139

Ordering information: This journal article can be ordered from
http://www.tandfonline.com/pricing/journal/UASA20

DOI: 10.1080/01621459.2020.1803883

Access Statistics for this article

Journal of the American Statistical Association is currently edited by Xuming He, Jun Liu, Joseph Ibrahim and Alyson Wilson

More articles in Journal of the American Statistical Association from Taylor & Francis Journals
Bibliographic data for series maintained by Chris Longhurst ().