Air quality improved but racial and ethnic disparities in deaths and disease widened, study finds

Deaths and disease linked to air pollution have dropped across the United States over the past few decades, but not all communities are equally reaping the benefits.

A new peer-reviewed study published in the journal Environmental Health Perspective found that the ethnic and racial disparities in rates of premature deaths and disease attributable to particulate matter and nitrogen dioxide have widened between 2010 and 2019.

There were nearly 50,000 premature deaths and over 100,000 new cases of pediatric asthma in the U.S, due to air pollution in 2019, a noticeable drop from years before.

Three of the cities with the highest pollution related mortality and morbidity are in the Midwest and the surrounding region.

Indiana had 1,636 premature deaths and 2,115 new cases of pediatric asthma due to pollution in 2019. That’s compared to Illinois, which had some of the highest rates in the Midwest — 2,683 premature deaths and 7,683 new cases of pediatric asthma due to pollution.
 

All population groups have seen a drop in air pollution in the U.S. thanks to the Clean Air Act and other legislative measures, according to Gaige Kerr, a senior research scientist at Milken Institute School of Public Health at George Washington University and one of the study authors.

But the gap between air pollution levels in White communities compared to communities of color has grown, he said. A lot of the pollution is anthropogenic, or human-caused, and these public health impacts could have been prevented.

“Even without air pollution, unfortunately, folks who live in marginalized communities often die younger,” Kerr said. “They're sicker because they have reduced access to nutritious food, or health care, etc.”

Ambient nitrogen dioxide pollution, which typically comes from cars and trucks in urban areas, is linked to increased rates of pediatric asthma. The pollutant that is most attributable to premature mortality is PM2.5 or soot –– tiny microscopic particles that are smaller than the diameter of a human hair –– which often comes from fossil fuels.

According to the study, the racial gap between the least and most White communities has widened by 16% for premature deaths related to or soot and 19% for nitrogen dioxide attributable pediatric asthma, between 2010 and 2019. And the ethnic disparities in rates of pediatric asthma and premature deaths attributable to these pollutants has widened by 10% and 40% respectively over the same period.

Although soot seems small, it can cause serious pronounced health impacts that lead to bronchitis and asthma, a disease that disproportionately shows up in communities of color. Soot attributable premature deaths were caused by stroke, ischemic heart disease, lung cancer, diabetes, and other medical issues.

Cities near the Ohio River Valley –– an area that’s home to former rust belts –– like Evansville and Kokomo, Ind., and Manfield, Ohio, are among the places with the highest mortality rates due to pollution. Areas with the highest rates of pediatric asthma due to pollution include Chicago, Ill. and Detroit, Mich.

Marginalized neighborhoods are more likely to have more pollution due to redlining and other racist zoning measures that has led to more refineries, power plants and highways in those areas.

For example, heavy-duty vehicles that use diesel, such as semi-trucks, contribute to air inequality despite being a small proportion of cars on the street, according to one of Kerr’s previous studies.

In 2019, the estimated direct costs of pediatric asthma and early deaths due to these pollutants was roughly $466 billion, or 2.2% of the country’s gross domestic product. Mortality accounted for 99.7% of the estimated costs.

Kerr said more stringent and specific air quality policies would help address this issue. Some of those could include stricter engine emission standards for vehicles, rethinking freight travel and expanding the use of trains and other forms of eco-efficient transportation.

“I'm not an expert in freight logistics, but I don't think at this point, we have the infrastructure to switch to trains or switch to electric vehicles,” he said. “So with that, in mind, a small solution that's not going to ameliorate all the issues, [is to] continue to shop local, go to the farmers market, don't rely on foods trucked in.”

Recently, the EPA announced that it will tighten the standards around soot in an effort to prevent up to 4,500 premature deaths in 2032. The Biden administration estimates that every $1 spent on this action would generate as much as $77 in health benefits.

Contact health reporter Elizabeth Gabriel at egabriel@wfyi.org.

Side Effects Public Media is a health reporting collaboration based at WFYI in Indianapolis. We partner with NPR stations across the Midwest and surrounding areas — including KBIA and KCUR in Missouri, Iowa Public Radio, Ideastream in Ohio and WFPL in Kentucky.