Maximizing Health Benefits and Minimizing Inequality: Incorporating Local-Scale Data in the Design and Evaluation of Air Quality Policies
Maximizing Health Benefits and Minimizing Inequality: Incorporating Local-Scale Data in the Design and Evaluation of Air Quality Policies
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DOI：
10.1111/j.1539-6924.2011.01629.x
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发表时间：
2011-06-01
期刊：
影响因子：
3.8
通讯作者：
Levy, Jonathan I.
中科院分区：
文献类型：
--
作者：
Fann, Neal;Roman, Henry A.;Levy, Jonathan I.
美国环境保护署在底特律大都市区进行了一项案例研究，以测试一种新的基于多污染物风险（MP/RB）的空气质量管理方法的可行性，该方法以空间分辨的空气质量，人口和基线健康数据为依据。案例研究表明，MP/RB方法使传统方法实现的人类健康效益增加了约一倍，同时增加的成本不到20%-更接近第12866号行政命令的目标，以最大限度地提高净效益。不太清楚的是，MP/RB和传统战略的健康福利分配如何影响底特律现有的空气污染相关风险的不平等。在这篇文章中，我们确定了底特律人口可能最容易受到空气污染的健康影响（基于当地规模的基线健康数据）和最容易受到空气污染（基于细尺度PM2.5空气质量模型和社会经济特征）。使用这些易感/脆弱的亚群配置文件，我们评估每种控制策略对风险不平等的相对影响，应用阿特金森指数（AI）来量化基线时的健康风险不平等，并采用风险管理方法。我们发现MP/RB方法在这些亚群中提供了更大的空气质量改善，同时也在低风险人群中产生了巨大的利益。应用AI，我们证实MP/RB策略比传统方法产生更少的PM2.5死亡率和哮喘住院风险不平等。我们证明了这种方法对政策制定者的价值，因为他们制定了具有成本效益的空气质量管理计划，最大限度地降低风险，同时最大限度地减少健康不平等。
The U.S. Environmental Protection Agency undertook a case study in the Detroit metropolitan area to test the viability of a new multipollutant risk-based (MP/RB) approach to air quality management, informed by spatially resolved air quality, population, and baseline health data. The case study demonstrated that the MP/RB approach approximately doubled the human health benefits achieved by the traditional approach while increasing cost less than 20%-moving closer to the objective of Executive Order 12866 to maximize net benefits. Less well understood is how the distribution of health benefits from the MP/RB and traditional strategies affect the existing inequalities in air-pollution-related risks in Detroit. In this article, we identify Detroit populations that may be both most susceptible to air pollution health impacts (based on local-scale baseline health data) and most vulnerable to air pollution (based on fine-scale PM2.5 air quality modeling and socioeconomic characteristics). Using these susceptible/vulnerable subpopulation profiles, we assess the relative impacts of each control strategy on risk inequality, applying the Atkinson Index (AI) to quantify health risk inequality at baseline and with either risk management approach. We find that the MP/RB approach delivers greater air quality improvements among these subpopulations while also generating substantial benefits among lower-risk populations. Applying the AI, we confirm that the MP/RB strategy yields less PM2.5 mortality and asthma hospitalization risk inequality than the traditional approach. We demonstrate the value of this approach to policymakers as they develop cost-effective air quality management plans that maximize risk reduction while minimizing health inequality.