The Health Impacts of Long-Run Exposure to Pollution in Adulthood and Later Life: Evidence from the US Army

其他项目信息-项目摘要/摘要

OTHER PROJECT INFORMATION – Project Summary/Abstract The Health Impacts of Long-Run Exposure to Pollution in Adulthood and Later Life: Evidence from the US Army A large body of observational studies link long-term pollution exposure to health harms, most notably mortality from cardiovascular disease and lung cancer (Dockery et al. 1993; Pope et al. 2004; Laden et al. 2006; Miller et al. 2007; Brook et al. 2010; Cerza et al. 2019; Lim et al. 2018; Qiu et al. 2018; Lipsett et al. 2011; Hoek et al. 2013, Beelen et al. 2014, Kaufman et al. 2016; Crouse et al. 2019). Since the original “Six Cities” study, many methodological advances have been made to better isolate a causal relationship between long-term pollution exposure and health. One factor that has received considerably less attention is the potential for confounding due to people’s ability to choose where they live. People can move to particular locations based on, at least in part, air pollution levels in that location. If people with more information and greater resources are more likely to move to locations with lower pollution (Banzhaf and Walsh, 2008; Gamper-Rabindran and Timmins, 2011, Finney, Goetzke and Yoon, 2011), it makes it challenging to distinguish whether poor health is caused by long- term exposure to pollution or by the myriad of other factors correlated with pollution. In this project, we aim to address these issues of residential confounding by focusing on military personnel. Military personnel are an ideal group for this purpose because they are constrained in their ability to choose residential locations to avoid pollution—their moves are determined by the needs of the Army. Therefore, pollution exposures for this group are likely to be independent from the multitude of other factors that affect health. Moreover, military personnel have uniform access to health care, such that the outcomes we study are unlikely to reflect access to care or ability to pay, but instead reflect underlying demand for medical care due to disease. Additionally, rich administrative data enables us to track the location and health care usage of personnel over long periods of time. We can integrate administrative data from multiple sources, including the Total Army Personnel Database, Tricare health care claims, and annual snapshots from the Veterans Health Agency in the Department of Veteran’s Affairs.