Environmental and health inequalities in England
PHE ePoster Library. Fecth D. Sep 12, 2019; 274479; 40
Dr. Daniela Fecth
Dr. Daniela Fecth
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Abstract Background Environmental factors, including deprivation, account for 23% of global deaths. Deprivation may magnify differences in environmental exposure levels (exposure differential), and in the susceptibility to develop health outcomes given a certain exposure (susceptibility differential). We examine inequalities in exposure and susceptibility to air pollutants in populations across England.
We estimated population-weighted mean annual concentrations of fine particulate matter (PM2.5) and nitrogen dioxide (NO2) derived from land use regression models for each Lower layer Super Output Area (LSOAs; ~1,500 residents). We analysed exposure gradients by deprivation using the Index of Multiple Deprivation (IMD), 2015. To evaluate the susceptibility differential, we regressed age-standardized rates of deaths from all causes (2000-2015) to exposure levels adjusting for relevant confounders and stratified the analysis by deprivation decile.
Preliminary results show a positive gradient of concentration by IMD decile, suggesting an exposure differential by deprivation. There were an average of ~488,000 deaths per annum. Of these, ~11% and ~8% occurred in the top most and least deprived IMD deciles, respectively. Our preliminary results show no difference in the magnitude of the association between PM2.5/NO2 with all-cause mortality by deprivation decile. We are currently exploring improvements in our statistical approach to account for spatial dependency and additional confounders.
This national study provides evidence on the exposure and susceptibility differential by area deprivation in relation to PM2.5 and NO2 concentrations across England. External funding details
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