Air pollution, deprivation and health: understanding relationships to add value to local air quality management policy and practice in Wales, UK
Air pollution, deprivation and health: understanding relationships to add value to local air quality management policy and practice in Wales, UK
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DOI：
10.1093/pubmed/fdw084
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发表时间：
2017-09-01
影响因子：
4.4
通讯作者：
Hayes, E.
中科院分区：
文献类型：
--
作者：
Brunt, H.;Barnes, J.;Hayes, E.
背景暴露于空气污染会降低人们的预期寿命。空气污染、贫困和糟糕的健康状况结合在一起，可能会增加和不成比例的疾病负担。问题和解决方案很少被放在广泛的公共卫生背景下考虑，但这样做可以通过减少空气污染风险、影响和不平等来增加空气质量管理努力的价值。方法一项生态学研究评估了英国威尔士空气污染(二氧化氮和颗粒物)、贫困状况和健康结果之间的小区域关联。结果空气污染浓度在最贫困的地区最高。当单独考虑时，剥夺健康与健康的关联比空气污染与健康的关联更强。同时考虑到，空气污染增加了剥夺健康的联系；空气污染和剥夺之间的相互作用改变并加强了与各种原因和呼吸系统疾病死亡率的关联，特别是在最脆弱的人生活的最贫困的地区，那里的健康需求最大。结论有必要降低所有人与空气污染相关的风险。然而，在更广泛的健康决定因素的背景下考虑当地空气污染问题和解决办法，并根据对关系的更好理解采取行动，也可以带来更大的健康收益。在高贫困和高污染地区，知情和协调的空气污染缓解和公共卫生行动可以减少风险和不平等。为了实现这一目标，需要在当地空气质量管理政策和实践中加强公共卫生一体化和协作。
Background Air pollution exposure reduces life expectancy. Air pollution, deprivation and poor-health status combinations can create increased and disproportionate disease burdens. Problems and solutions are rarely considered in a broad public health context, but doing so can add value to air quality management efforts by reducing air pollution risks, impacts and inequalities.Methods An ecological study assessed small-area associations between air pollution (nitrogen dioxide and particulate matter), deprivation status and health outcomes in Wales, UK.Results Air pollution concentrations were highest in 'most' deprived areas. When considered separately, deprivation-health associations were stronger than air pollution-health associations. Considered simultaneously, air pollution added to deprivation-health associations; interactions between air pollution and deprivation modified and strengthened associations with all-cause and respiratory disease mortality, especially in 'most' deprived areas where most-vulnerable people lived and where health needs were greatest.Conclusion There is a need to reduce air pollution-related risks for all. However, it is also the case that greater health gains can result from considering local air pollution problems and solutions in the context of wider health-determinants and acting on a better understanding of relationships. Informed and co-ordinated air pollution mitigation and public health action in high deprivation and pollution areas can reduce risks and inequalities. To achieve this, greater public health integration and collaboration in local air quality management policy and practice is needed.