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

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          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 (PM 2.5), ozone (O 3), sulfur dioxide (SO 2), and nitrogen dioxide (NO 2) 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 PM 2.5 and O 3 exposures, which cause 660 premature deaths each year among the 945,000 individuals in the study area. NO 2 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 NO 2 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.

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          Most cited references98

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          Quantifying the burden of disease: the technical basis for disability-adjusted life years.

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          Detailed assumptions used in constructing a new indicator of the burden of disease, the disability-adjusted life year (DALY), are presented. Four key social choices in any indicator of the burden of disease are carefully reviewed. First, the advantages and disadvantages of various methods of calculating the duration of life lost due to a death at each age are discussed. DALYs use a standard expected-life lost based on model life-table West Level 26. Second, the value of time lived at different ages is captured in DALYs using an exponential function which reflects the dependence of the young and the elderly on adults. Third, the time lived with a disability is made comparable with the time lost due to premature mortality by defining six classes of disability severity. Assigned to each class is a severity weight between 0 and 1. Finally, a three percent discount rate is used in the calculation of DALYs. The formula for calculating DALYs based on these assumptions is provided.
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              A review of land-use regression models to assess spatial variation of outdoor air pollution

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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                19 October 2017
                October 2017
                : 14
                : 10
                : 1243
                Affiliations
                [1 ]Environmental Health Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA; smarten@ 123456umich.edu (S.E.M.); cmilando@ 123456umich.edu (C.W.M.)
                [2 ]Detroiters Working for Environmental Justice, 4750 Woodward Ave., Suite 415, Detroit, MI 48201, USA; guy@ 123456detroitenvironmentaljustice.org
                Author notes
                [* ]Correspondence: stuartb@ 123456umich.edu ; Tel.: +1-734-763-2417
                Author information
                https://orcid.org/0000-0001-9206-5132
                Article
                ijerph-14-01243
                10.3390/ijerph14101243
                5664744
                29048385
                4e095643-9ef7-4193-8ae7-ec7ed345e51b
                © 2017 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 18 August 2017
                : 15 October 2017
                Categories
                Article

                Public health
                ambient air pollution,burden of disease,health impact assessment,urban health
                Public health
                ambient air pollution, burden of disease, health impact assessment, urban health

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