Systemic inequalities in indoor air pollution exposure in London, UK

Abstract

Deprived communities in many cities are exposed to higher levels of outdoor air pollution, and there is increasing evidence of similar disparities for indoor air pollution exposure. There is a need to understand the drivers for this exposure disparity in order to develop effective interventions aimed at improving population health and reducing health inequities. With a focus on London, UK, this paper assembles evidence to examine why indoor exposure to PM 2.5 , NO x and CO may disproportionately impact low-income groups. In particular, five factors are explored, namely: housing location and ambient outdoor levels of pollution; housing characteristics, including ventilation properties and internal sources of pollution; occupant behaviours; time spent indoors; and underlying health conditions. Evidence is drawn from various sources, including building physics models, modelled outdoor air pollution levels, time-activity surveys, housing stock surveys, geographical data, and peer-reviewed research. A systems framework is then proposed to integrate these factors, highlighting how exposure to high levels of indoor air pollution in low-income homes is in large part due to factors beyond the control of occupants, and is therefore an area of systemic inequality. POLICY RELEVANCEThere is increasing public and political awareness of the impact of air pollution on public health. Strong scientific evidence links exposure to air pollution with morbidity and mortality.

Air pollution exposure disparities in US public housing developments

“…A major impediment here is data availability since indoor air pollution estimates for PHDs are not currently available in the US. However, both outdoor and indoor pollution sources have been found to worsen indoor air quality in multifamily rental housing 45 , 46 . Residents of PHDs could be additionally burdened because households of lower socioeconomic status tend to spend more time at home due to lower employment levels 46 .…”

“…However, both outdoor and indoor pollution sources have been found to worsen indoor air quality in multifamily rental housing 45 , 46 . Residents of PHDs could be additionally burdened because households of lower socioeconomic status tend to spend more time at home due to lower employment levels 46 . Additionally, higher housing density in PHDs could lead to increased pollution exposure from neighboring housing units 46 , 47 .…”

“…Residents of PHDs could be additionally burdened because households of lower socioeconomic status tend to spend more time at home due to lower employment levels 46 . Additionally, higher housing density in PHDs could lead to increased pollution exposure from neighboring housing units 46 , 47 . Recent research indicates while both housing characteristics (e.g., building quality, volume, and ventilation) and occupant behavior (e.g., smoking and cooking practices) contribute to indoor air pollution exposure, these risks vary across socioeconomic groups, with lower income households (e.g., those in PHDs) exposed to higher levels of indoor air pollution 35 , 46 , 47 .…”

“…This combination of county (1,892) and median decade of housing stock (10) for each tract yielded a total of 7,492 clusters for the tract-level GEEs. Clusters were defined for the PHD-level analysis using the city in which the building was located, since federally subsidized rental housing within a particular city can be expected have to have certain similarities compared to those located elsewhere 46 . This resulted in a total of 3337 clusters of PHDs in the PHD-level GEE model.…”

Between Policy and Risk Communication: Coverage of Air Pollution in Ghanaian Newspapers

“…There has been growing interest in analysing coverage of air pollution in the media globally in recent years [ 1 , 2 , 3 , 4 , 5 ]. Known colloquially as the fourth estate for the powerful role the media plays in shaping social and political reality, increasing attention has been placed on understanding changes in public and political awareness of the impacts of air pollution on public health as a result of media framing [ 6 , 7 , 8 ]. Such research is particularly crucial in Low- and Middle-Income Countries (LMIC) which experience poor knowledge transfer of the health risks of air pollution [ 8 ].…”