A0544
Title: Air pollution and mortality at the intersection of race and social class
Authors: Xiao Wu - Columbia University (United States) [presenting]
Abstract: Black Americans are exposed to higher annual levels of air pollution than White Americans and may be more susceptible to its health effects. Low-income Americans may also be more susceptible to air pollution than high-income Americans. Relying on stratum-specific mortality data, with strata defined jointly according to individual-level factors (age, sex, race, and Medicaid eligibility), a causal inference method is developed for continuous exposures to estimate exposure-response curves using stratum-specific mortality data adjusted for observed confounders. The method incorporates an outcome model and an estimated inverse probability of exposure weight to adjust for confounding, which produces a doubly robust estimator. In an extensive analysis of 623 million person-years of Medicare data covering 73 million individuals aged 65 and older from 2000 through 2016, the relationship between annual PM2.5 exposure and mortality across subpopulations defined by race (Black vs. White) and income (Medicaid eligible vs. ineligible) is examined. It is found that higher-income Black persons, low-income White persons, and low-income Black persons may benefit more from lower PM2.5 levels than higher-income White persons. These findings underscore the importance of considering racial identity and income together when assessing health inequities.
