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-项目概要/摘要 成年期和晚年长期暴露于污染的健康影响：来自 美国陆军 大量的观察性研究将长期暴露于污染与健康危害联系起来，最明显的是死亡率 来自心血管疾病和肺癌（Dockery et al. 1993; Pope et al. 2004; Laden et al. 2006;米勒et al. 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，比伦等人2014，考夫曼等人2016; Crouse等人2019）。自最初的“六城”研究以来，许多 方法上的进步已经取得了更好的分离长期污染之间的因果关系， 暴露和健康。一个受到相当少关注的因素是潜在的混淆 因为人们有能力选择他们的居住地。人们可以移动到特定的位置，至少在 这一地区的空气污染水平。如果拥有更多信息和更多资源的人更有可能 搬到污染较低的地方（Banzhaf和沃尔什，2008年; Gamper-Rabindran和Timmins，2011年， Finney，Goetzke和Yoon，2011年），这使得区分健康状况不佳是否是由长期 长期暴露于污染或与污染相关的无数其他因素。 在这个项目中，我们的目标是通过关注军事人员来解决这些问题的住宅混淆。 军事人员是实现这一目的的理想群体，因为他们的选择能力受到限制 为了避免污染，他们的行动取决于军队的需要。因此，我们认为， 这一群体的污染暴露可能独立于众多其他影响因素， 健康此外，军事人员享有统一的医疗保健，因此我们研究的结果是 不太可能反映获得医疗服务的机会或支付能力，而是反映由于以下原因对医疗服务的潜在需求： 疾病此外，丰富的管理数据使我们能够跟踪人员的位置和医疗保健使用情况 在很长一段时间内。我们可以整合来自多个来源的管理数据，包括Total Army 人事数据库，Tricare医疗保健索赔，以及退伍军人健康机构的年度快照， 退伍军人事务部

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.