Disparities in the Impact of Air Pollution

The burden of air pollution is not evenly shared. Poorer people and some racial and ethnic groups are among those who often face higher exposure to pollutants and who may experience greater responses to such pollution. Many studies have explored the differences in harm from air pollution to racial or ethnic groups and people who are in a low socioeconomic position, have less education, or live nearer to major sources of pollution,1 including a workshop the American Lung Association held in 2001 that focused on urban air pollution and health inequities.2 The most recent EPA review of the research on the health effects of particle pollution concluded that nonwhite populations, especially blacks, faced higher risk from particle pollution.3

Many studies have looked at differences in the impact of air pollution on premature death. Recent studies have looked at the mortality in the Medicaid population and found that those who live in predominately black or African American communities suffered greater risk of premature death from particle pollution than those who live in communities that are predominately white.4 Another large study found that Hispanics and Asians, but especially blacks, had a higher risk of premature death from particle pollution than whites did. This study found that income did not drive the differences. Higher-income blacks who had higher income than many whites still faced greater risk than those whites, suggesting that the impact of other factors such as chronic stress as a result of discrimination may be playing a role.5 Other researchers have found greater risk for African Americans from hazardous air pollutants, including those pollutants that also come from traffic sources.6 Due to decades of residential segregation, African Americans tend to live where there is greater exposure to air pollution.7

Socioeconomic position also appears tied to greater harm from air pollution. Multiple large studies show evidence of that link. Low socioeconomic status consistently increased the risk of premature death from fine particle pollution among 13.2 million Medicare recipients studied in the largest examination of particle pollution-related mortality nationwide.8 In a 2008 study that found greater risk for premature death for communities with higher African American populations, researchers also found greater risk for people living in areas with higher unemployment or higher use of public transportation.9 A 2008 study of Washington, DC, found that while poor air quality and worsened asthma went hand in hand in areas where Medicaid enrollment was high, the areas with the highest Medicaid enrollment did not always have the strongest association of high air pollution and asthma attacks.10 A 2016 study of New Jersey residents found that the risk of dying early from long-term exposure to particle pollution was higher in communities with larger African American populations, lower home values and lower median income.11 Studies of Atlanta, GA, found that particle pollution increased the risk of asthma attacks for zip codes where poverty was high and among people eligible for Medicaid.12

Scientists have speculated that there are three broad reasons why disparities may exist. First, groups may face greater exposure to pollution because of factors ranging from racism to class bias to housing market dynamics and land costs. For example, pollution sources tend to be located near disadvantaged communities, increasing exposure to harmful pollutants. Second, low social position may make some groups more susceptible to health threats because of factors related to their disadvantage. Lack of access to health care, grocery stores and good jobs; poorer job opportunities; dirtier workplaces; and higher traffic exposure are among the factors that could handicap groups and increase the risk of harm. Finally, existing health conditions, behaviors or traits may predispose some groups to greater risk. For example, people of color are among the groups most at risk from air pollutants, and the elderly, African Americans, Mexican Americans and people living near a central city have higher incidence of diabetes.

People of color also may be more likely to live in counties with higher levels of pollution. Non-Hispanic blacks and Hispanics were more likely to live in counties that had worse problems with particle pollution, researchers found in a 2011 analysis. Non-Hispanic blacks were also more likely to live in counties with worse ozone pollution. Income groups, by contrast, differed little in these exposures. However, since few rural counties have monitors, the primarily older, non-Hispanic white residents of those counties lack information about the air quality in their communities.13

Unemployed people, those with low income or low education and non-Hispanic blacks were found to be more likely to live in areas with higher exposures to particle pollution in a 2012 study. However, the different racial/ethnic and income groups were often breathing very different kinds of particles; the different composition and structure of these particles may have different health impacts.14

  1. Institute of Medicine. Toward Environmental Justice: Research, Education, and Health Policy Needs. Washington, DC: National Academy Press, 1999; O’Neill MS, , et al. Health, wealth, and air pollution: Advancing theory and methods. Environ Health Perspect. 2003; 111: 1861-1870; Finkelstein et al. Relation between income, air pollution and mortality: A cohort study. CMAJ. 2003; 169: 397-402; Zeka A, Zanobetti A, Schwartz J. Short term effects of particulate matter on cause specific mortality: effects of lags and modification by city characteristics. Occup Environ Med. 2006; 62: 718-725.

  2. American Lung Association. Urban air pollution and health inequities: A workshop report. Environ Health Perspect. 2001; 109 (suppl 3): 357-374.

  3. U.S. EPA, 2019, Section 12.5.4.

  4. Kioumourtzoglou MA, Schwartz J, James P, Dominici F, Zanobetti A. PM2.5 and mortality in 207 us cities: Modification by temperature and city characteristics. Epidemiology, 2016; 27: 221-227.

  5. Di Q, et al, N Engl J Med, 2017.

  6. Apelberg BJ, Buckley TJ, White RH. Socioeconomic and racial disparities in cancer risk from air toxics in Maryland. Environ Health Perspect. 2005: 113: 693-699.

  7. Nardone A, Casey JA, Morello-Frosch R, Mujahid M, Balmes JR, Thakur N. Associations between historical residential redlining and current age-adjusted rates of emergency department visits due to asthma across eight cities in California: an ecological study. Lancet Planet Health. 2020:4(1):e24-e31.

  8. Zeger SL, Dominici F, McDermott A, Samet J. Mortality in the Medicare population and chronic exposure to fine particulate air pollution in urban centers (2000-2005). Environ Health Perspect. 2008: 116: 1614-1619.

  9. Bell ML, Dominici F. Effect modification by community characteristics on the short-term effects of ozone exposure and mortality in 98 US communities. Am J Epidemiol. 2008; 167: 986-997

  10. Babin S, Burkom H, Holtry R, Tabernero N, Davies-Cole J, Stokes L, Dehaan K, Lee D. Medicaid patient asthma-related acute care visits and their associations with ozone and particulates in Washington, DC, from 1994-2005. Int J Environ Health Res. 2008; 18 (3): 209-221.

  11. Wang Y, Kloog I, Coul BA, Kosheleva A, Zanobetti A, Schwartz JD. Estimating causal effects of long-term PM2.5 exposure on mortality in New Jersey. Environ Health Perspect. 2016; 124: 1182-1188.

  12. O'Lenick, CR et al. Assessment of neighbourhood-level socioeconomic status as a modifier of air pollution-asthma associations among children in Atlanta. J Epi Comm Health. 2017:71(2):129-136; Strickland MJ, et al. Modification of the effect of ambient air pollution on pediatric asthma emergency visits: susceptible subpopulations, Epidemiology. 2014; 25: 843-850.

  13. Miranda ML, Edwards SE, Keating MH, Paul CJ. Making the environmental justice grade: The relative burden of air pollution exposure in the United States. Int J Environ Res Public Health. 2011; 8: 1755-1771.

  14. Bell ML, Ebisu K. Environmental inequality in exposures to airborne particulate matter component in the United States. Environ Health Perspect. 2012; 120: 1699–1704.

Page last updated: November 17, 2022

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