Sociodemographic and geographic variation in mortality attributable to air pollution in the United States

Abstract

There are large differences in premature mortality in the USA by race/ethnicity, education, rurality, and social vulnerability index groups. Using existing concentration-response functions based on Cox proportional-hazards models, published particulate matter (PM2.5) air pollution estimates, population estimates at the tract level, and county-level mortality data from the US National Vital Statistics System, we estimated the degree to which these mortality discrepancies can be attributed to differences in exposure and susceptibility to PM2.5. We show that differences in mortality attributable to PM2.5 were consistently more pronounced between race/ethnicities than by education, rurality, or social vulnerability index, with the Black American population having by far the highest proportion of deaths attributable to PM2.5 in all years from 1990 to 2016. Our model estimates that over half of the difference in age-adjusted all-cause mortality between the Black American and non-Hispanic White population was attributable to PM2.5 in the years 2000 to 2011.