Disease and Health Inequalities Attributable to Air Pollutant Exposure in Detroit, Michigan

Sheena E Martenies, Chad W Milando, Guy O Williams, Stuart A Batterman, Sheena E Martenies, Chad W Milando, Guy O Williams, Stuart A Batterman

Abstract

The environmental burden of disease is the mortality and morbidity attributable to exposures of air pollution and other stressors. The inequality metrics used in cumulative impact and environmental justice studies can be incorporated into environmental burden studies to better understand the health disparities of ambient air pollutant exposures. This study examines the diseases and health disparities attributable to air pollutants for the Detroit urban area. We apportion this burden to various groups of emission sources and pollutants, and show how the burden is distributed among demographic and socioeconomic subgroups. The analysis uses spatially-resolved estimates of exposures, baseline health rates, age-stratified populations, and demographic characteristics that serve as proxies for increased vulnerability, e.g., race/ethnicity and income. Based on current levels, exposures to fine particulate matter (PM2.5), ozone (O₃), sulfur dioxide (SO₂), and nitrogen dioxide (NO₂) are responsible for more than 10,000 disability-adjusted life years (DALYs) per year, causing an annual monetized health impact of $6.5 billion. This burden is mainly driven by PM2.5 and O₃ exposures, which cause 660 premature deaths each year among the 945,000 individuals in the study area. NO₂ exposures, largely from traffic, are important for respiratory outcomes among older adults and children with asthma, e.g., 46% of air-pollution related asthma hospitalizations are due to NO₂ exposures. Based on quantitative inequality metrics, the greatest inequality of health burdens results from industrial and traffic emissions. These metrics also show disproportionate burdens among Hispanic/Latino populations due to industrial emissions, and among low income populations due to traffic emissions. Attributable health burdens are a function of exposures, susceptibility and vulnerability (e.g., baseline incidence rates), and population density. Because of these dependencies, inequality metrics should be calculated using the attributable health burden when feasible to avoid potentially underestimating inequality. Quantitative health impact and inequality analyses can inform health and environmental justice evaluations, providing important information to decision makers for prioritizing strategies to address exposures at the local level.

Keywords: ambient air pollution; burden of disease; health impact assessment; urban health.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Map showing the full study area boundary and the study boundaries used in the sensitivity analyses. Black diamonds show the location of ambient air quality monitors in the area. The shaded area has been classified as non-attainment with the SO2 national ambient air quality standard (NAAQS).
Figure 2
Figure 2
Maps showing the annual health burden as DALYs per 10,000 persons per year attributable to exposures from: all sources (A); and exposures from: regional sources (B); point sources (C); mobile sources (D); and area sources (E).
Figure 3
Figure 3
Annual average ambient concentrations from point sources of: PM2.5 (A); and SO2 (B). Percentage of the population identifying as: Hispanic or Latino (C); or as persons of color (excludes non-Hispanic whites) (D).

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