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Racial/ethnic disparities in the associations between environmental quality and mortality in the contiguous U.S.
Jian, Y., L. Messer, C. Gray, S. Grabich, J. Jagai, K. Rappazzo, AND D. Lobdell. Racial/ethnic disparities in the associations between environmental quality and mortality in the contiguous U.S. International Society for Environmental Epidemiology, Rome, ITALY, September 01 - 04, 2016.
The purpose of this study was to explore racial/ethnic disparities in relation to overall environmental quality and all-cause and cause-specific mortality in the U.S., accounting for climate regions and rural/urban distinctions. This study utilized the EPA created Environmental Quality Index.
Introduction: Understanding racial/ethnic disparities in mortality is an important goal for public health in the U.S. We examined the role environmental quality may have on mortality across race/ethnicity. Methods: The Environmental Quality Index (EQI) and its domain indices (air, water, land, built and sociodemographic) were used to represent cumulative environmental quality. We assessed the associations between EQI and age-adjusted all-cause death rates for counties in the contiguous U.S. (n=3109) for Hispanic, non-Hispanic Asian or Pacific Islander (NH Asian), NH Black or African American (NH Black), NH American Indian or Alaska Native (NH Native), and NH White populations. We performed random intercept and slope models clustered by: race/ethnicity, race/ethnicity and urbanicity, and race/ethnicity and climate regions. Results are reported as % change in mortality (95% confidence interval (CI)) per 1 standard deviation increase in EQI. Results: We found positive associations between worse environmental quality and mortality for NH Asian (3.6% (0.6%, 6.6%)) and NH White (1.1% (0.3%, 2.0%)), and negative associations for other races/ethnicities (e.g., Hispanic -7.0% (-8.5%, -5.5%)). Among the five domains, air was positively associated with mortality for NH Black (1.4% (-0.7%, 3.4%)) and NH White (4.2% (3.4%, 5.0%)). Built was positively associated with mortality for all racial/ethnic groups. The sociodemographic index was positively associated with mortality for NH Native (10.1% (8.2%, 12.0%)). We also found the associations between EQI and mortality varied for urbanicity and climate within each race/ethnicity. Conclusions: This study was the first attempt to assess the racial/ethnic disparities in the associations between cumulative environmental quality and mortality. Results suggest that associations vary by race/ethnicity, which may inform environmental interventions towards vulnerable groups. This abstract does not represent EPA policy.