Socioeconomic and urban-rural differentials in exposure to air pollution and mortality burden in England

Abstract

Background: Socioeconomically disadvantaged populations often have higher exposures to particulate air pollution, which can be expected to contribute to differentials in life expectancy. We examined socioeconomic differentials in exposure and air pollution-related mortality relating to larger scale (5 km resolution) variations in background concentrations of selected pollutants across England. Methods: Ozone and particulate matter (sub-divided into PM 10 , PM 2.5 , PM 2.5-10 , primary, nitrate and sulphate PM 2.5 ) were simulated at 5 km horizontal resolution using an atmospheric chemistry transport model (EMEP4UK). Annual mean concentrations of these pollutants were assigned to all 1,202,578 residential postcodes in England, which were classified by urban-rural status and socioeconomic deprivation based on the income and employment domains of the 2010 English Index of Multiple Deprivation for the Lower-level Super Output Area of residence. We used life table methods to estimate PM 2.5 -attributable life years (LYs) lost in both relative and absolute terms. Results: Concentrations of the most particulate fractions, but not of nitrate PM 2.5 or ozone, were modestly higher in areas of greater socioeconomic deprivation. Relationships between pollution level and socioeconomic deprivation were non-linear and varied by urban-rural status. The pattern of PM 2.5 concentrations made only a small contribution to the steep socioeconomic gradient in LYs lost due to PM 2.5 per 10 3 population, which primarily was driven by the steep socioeconomic gradient in underlying mortality rates. In rural areas, the absolute burden of air pollution-related LYs lost was lowest in the most deprived deciles. Conclusions: Air pollution shows modest socioeconomic patterning at 5 km resolution in England, but absolute attributable mortality burdens are strongly related to area-level deprivation because of underlying mortality rates. Measures that cause a general reduction in background concentrations of air pollution may modestly help narrow socioeconomic differences in health.

Connecting Air Pollution Exposure to Socioeconomic Status: A Cross-Sectional Study on Environmental Injustice among Pregnant Women in Scania, Sweden

“…As no previous literature exists regarding particulate matter exposure and socioeconomic status within this study setting, studies from other European countries were considered. To begin, higher concentrations of various PM fractions were detected in neighborhoods composed of >20% non-white persons in England and non-Western immigrants the Netherlands [66].This trend continued among low-SES persons, specifically including low education, in an Italian study [2]as well as among the most deprived neighborhoods in England [16,66] and France [9]. These European studies correspond to our presented results, especially throughout the entire MAPSS study population and Malmö, with few deviations.…”

Social Inequalities in Exposure to Ambient Air Pollution: A Systematic Review in the WHO European Region

“…The first broad finding is that all seven studies support the contention that higher exposure to air pollutants is linked to lower social dimensions. In Wales [39] the most deprived areas are exposed to the highest levels of NO 2 , PM 10 , and PM 2.5 and a similar finding for all but one type of particulate is found for England using postcode data [45].…”

The distributional aspects of environmental quality and environmental policies

“…While the associations between socioeconomic characteristics and environmental quality mostly defy broad generalisation, the importance of cities or the urban-rural divide is regularly highlighted and several studies find environmental inequality to be particularly an urban issue (e.g., Science for Environment Policy, 2016;Nieuwenhuijsen 2016;Fecht et al 2015;Milojevic et al 2017). Box 2.2 highlights some of the reasons why cities are relevant in this context.…”

“…Interestingly, this differential vulnerability suggests that improvements to environmental quality that benefit everyone, such as the reduction of background air pollution, may benefit disadvantaged groups the most (e.g. Milojevic et al 2017). It also means that it may be more effective to focus on improving environmental conditions for poorer groups.…”