Children's exposure to vehicular pollution: Environmental injustice in Texas, USA

The Association of Socio-Environmental Inequality and Outcomes Among Patients Undergoing Major Surgery

INTRODUCTION

Environmental hazards may influence health outcomes and be a driver of health inequalities. We sought to characterize the extent to which social-environmental inequalities were associated with surgical outcomes following a complex operation.

METHODS

In this cross-sectional study, patients who underwent abdominal aortic aneurysm repair, coronary artery bypass grafting, colectomy, pneumonectomy, or pancreatectomy between 2016 and 2021 were identified from Medicare claims data. Patient data were linked with social-environmental data sourced from Centers for Disease Control and Agency for Toxic Substances and Disease Registry data based on county of residence. The Environmental Justice Index social-environmental ranking (SER) was used as a measure of environmental injustice. Multivariable regression analysis was performed to assess the relationship between SER and surgical outcomes.

RESULTS

Among 1,052,040 Medicare beneficiaries, 346,410 (32.9%) individuals lived in counties with low SER, while 357,564 (33.9%) lived in counties with high SER. Patients experiencing greater social-environmental injustice were less likely to achieve textbook outcome (odds ratio 0.95, 95% confidence interval 0.94-0.96, P < 0.001) and to be discharged to an intermediate care facility or home with a health agency (odds ratio 0.97, 95% confidence interval 0.96-0.98, P < 0.001).

CONCLUSIONS

Cumulative social and environmental inequalities, as captured by the Environmental Justice Index SER, were associated with postoperative outcomes among Medicare beneficiaries undergoing a range of surgical procedures. Policy makers should focus on environmental, as well as socioeconomic injustice to address preventable health disparities.

Association of road traffic noise exposure and school childrens' cognition: A structural equation model approach

This study explores the complex relationship between traffic noise and school children's cognition, acknowledging existing empirical inconsistencies and aiming to contribute to a richer understanding of this pivotal issue. Schools adjacent to noisy roads were selected, and outdoor noise levels were measured employing a Kimo dB300 sound level meter, focusing on noise level indices LAeq, L10, and L90. Subsequent calculations were performed to determine the noise pollution level (Lnp), noise climate (NC), and traffic noise index (TNI), revealing a severe noise exposure when compared to standard guidelines. A perception questionnaire for various noise and acoustic factors influencing cognition was developed, and 1524 student responses were collected. Data analysis incorporated Principal Component Analysis (PCA) and Exploratory Factor Analysis (EFA) for dimension reduction, revealing three latent factors labelled 'annoyance,' 'behaviour,' and 'cognition'. Further, Structural Equation Modeling (SEM) was utilized to explore multivariate relationships between variables and latent factors. Resultant path coefficients were obtained as 0.12, 0.98, and 0.10 for the impact of 'behaviour' and 'annoyance' on 'cognition' and the correlation between 'annoyance' and 'behaviour', respectively. Findings underscore a potent positive impact of annoyance, stemming from acute ambient noise exposure, on the deterioration of children's cognition. While suggesting that ambient noise may be correlated with adverse health impacts due to its influence on cognition, this study emphasizes the pressing necessity for noise mitigation in roadside schools and stringent enforcement of noise pollution guidelines in academic zones.

Demographic and Psychosocial Characteristics, Air Pollution Exposure, and Housing Mobility of Mexican Immigrant Families

OBJECTIVE

People of color and lower socioeconomic status groups in the USA, including those of Mexican origin, are exposed to higher concentrations of air pollution, including fine particulate matter (PM2.5). Associations were examined between neighborhood air pollution levels and the psychosocial and demographic characteristics of linguistically isolated Mexican-origin immigrant families. Housing mobility and changes in air pollution levels due to changes in residence were also examined.

METHODS

A sample of 604 linguistically isolated Mexican-origin families in central TX provided data on demographic and psychosocial experiences. Outdoor air pollution concentrations at participants' home addresses were based on high-resolution estimates of fine particulate matter (PM2.5) and its constituents. Movers were identified as families whose residential addresses changed during the study period; these participants were further grouped and compared based on the change in their residential PM2.5 concentration from before to after their move.

RESULTS

Lower PM2.5 concentrations were associated with reports of more ethnic discriminatory experiences, higher socioeconomic status, and higher perceived neighborhood safety. Among the 23% of families who changed residences, PM2.5 concentrations were generally lower at the new family address. Families with mothers reporting a greater sense of neighborhood safety or acculturation levels tended to move from one area low in air pollutants to another, and mothers reporting the lowest levels of neighborhood safety or acculturation tended to move from one area high in air pollutants to another.

CONCLUSION

There are limits to assimilation for Mexican immigrant families. Living in more advantaged neighborhoods is associated with experiencing better air quality, but this advantage may come at the cost of experiencing more ethnic discrimination.

Social Inequities in Exposure to Traffic-Related Air and Noise Pollution at Public Schools in Texas

Although children are particularly vulnerable to the adverse impacts of vehicular pollution and spend significant portions of their time at school, previous studies have not examined or compared school-level social inequities in exposure to both traffic-related air and noise pollution in the same study area. We addressed this gap through a case study in Texas-the second-largest US state based on total population and number of children. Vehicular pollution exposure was measured using: (1) outdoor concentrations of nitrogen dioxide (NO₂), a widely used proxy for traffic-related air pollution; and (2) road noise estimates from the US Department of Transportation's National Transportation Noise Mapping Tool. These variables were linked to data on locations and sociodemographic characteristics of children enrolled in Texas public schools. We found children attending schools with the highest exposure to both NO₂ and road noise (top 25%) were significantly more likely to be Black, Hispanic, and eligible for free/reduced lunches (socioeconomically deprived). Results from multivariable generalized estimating equations that control for spatial clustering and other relevant factors revealed that schools with greater NO₂ exposure were significantly more likely to serve racial/ethnic minority and younger students, while schools with greater exposure to road noise were significantly more likely to serve socioeconomically deprived and older students. These findings underscore the urgent need to reduce both air pollution and noise exposure at school locations, especially in schools attended by higher proportions of socially disadvantaged children that are often additionally burdened with other challenges.

Disparities in exposure to fine particulate air pollution for people with disabilities in the US

Although chronic air pollution has been found to be disproportionately distributed with respect to race/ethnicity and socioeconomic status in the US, previous research on social disparities in air pollution exposure has not focused on persons with disabilities (PwDs). This gap is addressed here by conducting the first national-scale study of the relationship between outdoor exposure to fine particulate matter (PM_2.5) and disability status in the continental US. Census tract-level data on average annual PM_2.5 concentrations (2011-2015) were linked with relevant variables from the 2015 American Community Survey five-year estimates. Statistical analyses were based on bivariate and multivariable generalized estimating equations that account for spatial clustering of tracts within counties. Results indicated that the overall percentage of civilian noninstitutionalized persons with a disability and multiple types of disability are higher in neighborhoods with greater PM_2.5 exposure, after controlling for race/ethnicity, poverty, renter occupancy, older age, population density, and metropolitan status. The percentages of PwDs with cognitive and independent living difficulties indicated stronger positive associations with PM_2.5 exposure, compared to those with other types of difficulties. These findings represent an important starting point for more detailed research investigations and policy interventions that seek to mitigate disproportionate air pollution exposure for this vulnerable group.

The Intersection of Immigrant and Environmental Health: A Scoping Review of Observational Population Exposure and Epidemiologic Studies

BACKGROUND

Transnational immigration has increased since the 1950s. In countries such as the United States, immigrants now account for > 15 % of the population. Although differences in health between immigrants and nonimmigrants are well documented, it is unclear how environmental exposures contribute to these disparities.

OBJECTIVES

We summarized current knowledge comparing immigrants' and nonimmigrants' exposure to and health effects of environmental exposures.

METHODS

We conducted a title and abstract review on articles identified through PubMed and selected those that assessed environmental exposures or health effects separately for immigrants and nonimmigrants. After a full text review, we extracted the main findings from eligible studies and categorized each article as exposure-focused, health-focused, or both. We also noted each study's exposure of interest, study location, exposure and statistical methods, immigrant and comparison groups, and the intersecting socioeconomic characteristics controlled for.

RESULTS

We conducted a title and abstract review on 3,705 articles, a full text review on 84, and extracted findings from 50 studies. There were 43 studies that investigated exposure (e.g., metals, organic compounds, fine particulate matter, hazardous air pollutants) disparities, but only 12 studies that assessed health disparities (e.g., mortality, select morbidities). Multiple studies reported higher exposures in immigrants compared with nonimmigrants. Among immigrants, studies sometimes observed exposure disparities by country of origin and time since immigration. Of the 50 studies, 43 were conducted in North America.

DISCUSSION

The environmental health of immigrants remains an understudied area, especially outside of North America. Although most identified studies explored potential exposure disparities, few investigated subsequent differences in health effects. Future research should investigate environmental health disparities of immigrants, especially outside North America. Additional research gaps include the role of immigrants' country of origin and time since immigration, as well as the combined effects of immigrant status with intersecting socioeconomic characteristics, such as race/ethnicity, income, and education attainment. https://doi.org/10.1289/EHP9855.