Social Susceptibility to Multiple Air Pollutants in Cardiovascular Disease

Authors: Ellen J. Kinnee*, University of Pittsburgh, Jamie L. Humphrey, Drexel University Dornsife School of Public Health, Laura D. Kubzansky, Harvard T.H. Chan School of Public Health, Colleen E. Reid, University of Colorado at Boulder, Leslie A. McClure, Drexel University Dornsife School of Public Health, Lucy Robinson, Drexel University Dornsife School of Public Health, Jane E. Clougherty, Drexel University Dornsife School of Public Health
Topics: Medical and Health Geography, Spatial Analysis & Modeling, Geography and Urban Health
Keywords: Air pollution modeling; socioeconomic status; effect modification; crime stressors; cardiovascular disease
Session Type: Poster
Day: 4/6/2019
Start / End Time: 9:55 AM / 11:35 AM
Room: Lincoln 2, Marriott, Exhibition Level
Presentation File: No File Uploaded


Cardiovascular disease (CVD), the leading cause of death in the US, has been linked to chronic and acute air pollution exposures. Research has identified stronger effects of air pollution in lower-socioeconomic position (SEP) communities, where exposures are often higher. While specific factors leading to this susceptibility remain unknown, chronic psychosocial stress related to social adversity has been hypothesized as a critical component. In this study, we examine associations between air pollution exposures and CVD events using a case-crossover design and assess effect modification of these associations by SEP and/ or specific chronic stressor exposures. Our analyses use four unique datasets to assess exposure relationships: [1] Spatial data on citywide SEP and stressor indicators; [2] Surfaces for fine-scale spatial variation in multiple pollutants from NYC Community Air Survey [ PM2.5, nitrogen dioxide (NO2), summertime ozone (O3), sulfur dioxide (SO2)]; [3] Daily ambient pollution concentrations from EPA AQS monitors; [4] Complete data on in- and out-patient unscheduled CVD events in NYC emergency departments (ED) 2005-2011 (n = 1.3 million), from NY State Department of Health Statewide Planning and Research Cooperative System. Preliminary results suggest a 1.0 to 3.5% increases in excess risk of CVD ED visits – for both overall CVD risk and key sub-diagnoses with a 10-ppb increase in NO2 and PM2.5 exposure on lag days 0-1. We find suggestive evidence of effect modification by SEP and stressors including violent crime; with the lowest risk of a CVD event in communities in the lowest-crime quartile, and increasing risks with increasing crime.

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