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Abstract WMP57: Geographic Disparities in Stroke and Life Expectancy Significantly Attributable to Ambient PM2.5 Pollution Across the Counties of the United States
Journal article   Peer reviewed

Abstract WMP57: Geographic Disparities in Stroke and Life Expectancy Significantly Attributable to Ambient PM2.5 Pollution Across the Counties of the United States

Longjian Liu and for Air Quality and Population Health Rsch Group
Stroke (1970), v 50(Suppl_1)
Feb 2019
DOI: https://doi.org/10.1161/str.50.suppl_1.WMP57

Abstract

Background: We aimed to test the hypotheses that ambient particulate matter (PM2.5) is significantly associated with the risk of stroke mortality and life expectancy (LE) reduction, and the degrees of these associations differ across the counties and regions of the United States (U.S). Methods: Annual average county-level data (n=1561 counties) from U.S. Centers for Disease Control and Prevention, and Environmental Protection Agency on PM2.5 measures in 2005-2010, age-adjusted stroke mortality in adults aged ≥35 in 2013-2015, and LE in 2010, as well as % of poverty rate, number of primary care physicians per 1000 residents (as a marker of healthcare support) and county-level % of rural population as covariates were analyzed using linear and multilevel hierarchical regression analyses. Results: Significant county-level variations in annual average PM2.5 levels (range: 7.2-14.7 ug/ 3 ), stroke mortality (30.1-219.0 per 100,000 population in males, and 35.0-249.0 in females), and LE (65.0-81.7 years in males and 72.7-85.0 in females) were observed across the nation. Population-weighted PM2.5 levels were significantly and positively associated with stroke mortality in males (r=0.49, p<.0001), and in females (r=0.42, p<.0001), and negatively associated with LE in males (r=-0.39, p<.0001) and females (r=-0.37, p<.0001). Adjusted multilevel analysis indicates that PM2.5 was significantly associated with stroke mortality rates (β=1.27, p<.0001) in both sexes, and with LE in males (β=-0.18, p=<.001), and in females (β=-0.09, p<.001). The adverse impacts of PM2.5 were even worse in counties with higher % of poverty rates and poorer healthcare support compared to their counterparts. Analyses by regions indicate that the highest risk of PM2.5 for stroke (assessed by regression coefficients) was shown for males and females living in the South, followed by Midwest, Northeast, and West. Similar results of the risk of PM2.5 for LE reduction were observed across the regions. Conclusion: The study, using U.S. national representative datasets provides new and important evidence that geographic disparities in stroke mortality and LE are significantly attributable to ambient PM2.5 pollution across the nation.

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