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Environmental quality impact on human mortality and its spatial variations in the contiguous United States 2000-2005
Citation:
Jian, Y., L. Messer, S. Grabich, J. Jagai, K. Rappazzo, C. Gray, AND D. Lobdell. Environmental quality impact on human mortality and its spatial variations in the contiguous United States 2000-2005. Epidemiology Congress of the Americas 2016, Miami, FL, June 21 - 24, 2016.
Impact/Purpose:
The purpose of this study was to explore overall environmental quality in relation to 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.
Description:
Assessing the cumulative effects of multiple environmental factors that influence mortality remains a challenging task. This study used the Environmental Quality Index (EQI), and its five domain indices (air, water, land, built and sociodemographic) as a measure of cumulative environmental exposure. Associations between EQI and all-cause and leading cause-specific (heart disease, stroke, and cancer) death rates for counties in the contiguous U.S. (n=3109) were investigated. Random intercept and slope models clustered by climate and rural-urban setting were used to study the spatial variations of effects; heterogeneity across race groups was also examined using random intercept and slope model clustered by race. Population density, smoking and alcohol consumption were adjusted in the models. We found, on average, one standard deviation increase in overall EQI (worse environment) was associated with 2.4% (±0.8%) increase in all-cause death rate, -0.2 % (±1.1%) change in heart disease death rate, 2.8% (±0.7%) increase in cancer death rate, and 3.7% (±01.4%) increase in stroke death rate. Among environmental domains, air had the strongest adverse effect on all-cause death rate (3.6% (±0.4%) increase per 1 standard increase in air EQI), and on heart-disease (3.1% (±1.4%)) and cancer (2.4% (±0.5%)) death rates. The sociodemographic domain had the most adverse effects on stroke death rate (4.0% (±1.2%)). Spatially the strongest overall environmental effects were found in the southwest U.S. Finally, for different races, all-cause death was most adversely influenced by air quality for white (7.4% (±0.5%)), African American (3.9% (±1.0%)), and Asian (5.8% (±1.8%)), while all-cause death rate of American Indian was most adversely influenced by sociodemographic environment (10.9% (±0.7%)). These results suggest that poor environmental quality, particularly air quality, increases mortality, and that effects vary by race. This abstract does not represent EPA policy.