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Kephart JL, Bilal U, Gouveia N, Sarmiento OL, Shingara E, Moreno KR, Bakhtsiyarava M, Rodriguez JP, Ayala S, Carrasco-Escobar G, Diez Roux AV. Social disparities in flood exposure and associations with the urban environment in 44,698 neighborhoods in 276 cities in eight Latin American countries. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.07.02.24309839. [PMID: 39006415 PMCID: PMC11245088 DOI: 10.1101/2024.07.02.24309839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
Background Climate change is expected to greatly increase exposure to flooding, particularly in urban populations in low- and middle-income countries. We examined within-city social disparities in exposure to flooding in 276 Latin American cities and associated features of the neighborhood urban environment. Methods We used a spatially granular dataset of historical flood events from 2000 to 2018 to describe neighborhood flooding within cities across eight Latin American countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Guatemala, Mexico, and Panama). We estimated the percentage of the population living in flooded neighborhoods, described social disparities in flooding based on neighborhood educational attainment, and compared the magnitude of disparities across and within cities. We used multilevel models to examine how city- and neighborhood-level factors are related to neighborhood flooding. Results We examined 44,698 neighborhoods in 276 cities from eight countries with a total of 223 million residents and 117 distinct flood events from 2000-2018. One in four residents in neighborhoods in the lowest education quintile lived in neighborhoods with flooding, compared to one in 20 residents of the highest neighborhood education quintile. Greater neighborhood flooding was associated with lower neighborhood-level educational attainment and with neighborhoods that were coastal, less dense (population or intersection), further from the city center, greener, and had steeper slopes. There was no association between city-level educational attainment and flooding. Conclusion There are large social disparities in neighborhood flooding within Latin American cities. Residents of areas with lower education attainment face substantially higher risks of flooding. Policymakers must prioritize flood adaptation and recovery efforts in neighborhoods with lower socioeconomic position.
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Affiliation(s)
- Josiah L. Kephart
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, USA
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, USA
| | - Usama Bilal
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, USA
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, USA
| | - Nelson Gouveia
- University of São Paulo Medical School, São Paulo, Brazil
| | | | - Emily Shingara
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, USA
| | | | - Maryia Bakhtsiyarava
- Institute of Transportation Studies, University of California Berkeley, Berkeley, USA
| | - Juan Pablo Rodriguez
- Department of Civil and Environmental Engineering, Universidad de Los Andes, Bogotá, Colombia
| | - Salvador Ayala
- Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Gabriel Carrasco-Escobar
- Health Innovation Laboratory, Alexander von Humboldt Institute of Tropical Medicine, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Ana V Diez Roux
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, USA
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, USA
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Gouveia N, Rodriguez-Hernandez JL, Kephart JL, Ortigoza A, Betancourt RM, Sangrador JLT, Rodriguez DA, Diez Roux AV, Sanchez B, Yamada G. Short-term associations between fine particulate air pollution and cardiovascular and respiratory mortality in 337 cities in Latin America. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 920:171073. [PMID: 38382618 PMCID: PMC10918459 DOI: 10.1016/j.scitotenv.2024.171073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/29/2024] [Accepted: 02/16/2024] [Indexed: 02/23/2024]
Abstract
Ambient air pollution is a health concern in Latin America given its large urban population exposed to levels above recommended guidelines. Yet no studies have examined the mortality impact of air pollutants in the region across a wide range of cities. We assessed whether short-term levels of fine particulate matter (PM2.5) from modeled estimates, are associated with cardiovascular and respiratory mortality among adults in 337 cities from 9 Latin American countries. We compiled mortality, PM2.5 and temperature data for the period 2009-2015. For each city, we evaluated the association between monthly changes in PM2.5 and cardiovascular and respiratory mortality for sex and age subgroups using Poisson models, adjusted for seasonality, long-term trend, and temperature. To accommodate possibly different associations of mortality with PM2.5 by age, we included interaction terms between changes in PM2.5 and age in the models. We combined the city-specific estimates using a random effects meta-regression to obtain mortality relative risks for each sex and age group. We analyzed 3,026,861 and 1,222,623 cardiovascular and respiratory deaths, respectively, from a study population that represents 41 % of the total population of Latin America. We observed that a 10 μg/m3 increase in monthly PM2.5 is associated with an increase of 1.3 % (95 % confidence interval [CI], 0.4 to 2.2) in cardiovascular mortality and a 0.9 % increase (95 % CI -0.6 to 2.4) in respiratory mortality. Increases in mortality risk ranged between -0.5 % to 3.0 % across 6 sex-age groups, were larger in men, and demonstrated stronger associations with cardiovascular mortality as age increased. Socioeconomic, environmental and health contexts in Latin America are different than those present in higher income cities from which most evidence on air pollution impacts is drawn. Locally generated evidence constitutes a powerful instrument to engage civil society and help drive actions to mitigate and control ambient air pollution.
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Affiliation(s)
- Nelson Gouveia
- Department of Preventive Medicine, University of Sao Paulo Medical School, Sao Paulo, Brazil.
| | | | - Josiah L Kephart
- Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, USA; Department of Environmental and Occupational Health, Drexel Dornsife School of Public Health, Philadelphia, USA
| | - Ana Ortigoza
- Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, USA; Department of Environmental and Social determinants for Health Equity, Pan American Health Organization, USA
| | | | | | - Daniel A Rodriguez
- Institute of Transportation Studies, University of California, Berkeley, CA, USA; Department of City and Regional Planning and Institute Transportation Studies, University of California, Berkeley, USA
| | - Ana V Diez Roux
- Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, USA; Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Philadelphia, USA
| | - Brisa Sanchez
- Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Philadelphia, USA
| | - Goro Yamada
- Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, USA
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