Air Pollution, Heat, Cold, and Health: Disparities in the Rural South

农村地区的许多人口，特别是少数种族和族裔群体， 环境健康负担，如空气污染或极端温度。然而，绝大多数 关于环境健康差异的研究（即，“环境正义”）的空气污染，以及研究 关于空气污染和健康更普遍的，是为城市进行的。人民、社区和空气污染 在农村和城市环境中，污染源和混合物是截然不同的，因此国家战略（即，联邦 这些措施（例如，卫生条例）可能无法充分保护农村人口的健康。同样，关于健康的研究 高温和低温的后果，特别是对于长时间的热（即，“热浪”）， 几乎完全集中在城市地区。因此，目前的研究在如何解决这一问题上存在重大科学空白。 农村人口的健康，包括农村种族和少数民族群体，受到空气污染的影响， 极端温度南部农村地区，特别是阿巴拉契亚地区， 与全国平均水平相比，老年人（> 65岁）和婴儿的结果。在南方，农村 与城市人口相比，城市人口的多种疾病发病率更高， 与城市环境中的空气污染和极热极冷有关。农村居民也较低 总体收入、较低的教育程度、较少获得医疗保健的机会以及预期寿命缩短三年 比城市里的人要多有证据表明，农村少数民族的种族健康差距更大 比城市里的人要多鉴于人口、行为、环境危害和 社会经济地位（SES），空气污染，极端温度和健康之间的联系可能 在农村和城市环境中差别很大。这些关系在不同类型的农村地区也可能不同， 考虑到农村环境的多样性。迫切需要科学证据， 农村环境中空气污染和极端温度的影响，了解 农村环境。我们的长期目标是生成能够实现以下目标的方法、数据库和科学估计 保护农村人口健康的知识。我们建议：1）生成空中数据架构 污染，热，冷，健康，社会经济地位，农村形式和其他因素在弗吉尼亚州和西弗吉尼亚州; 2）估计 按种族/民族、社会经济地位和气候（寒冷、炎热和热浪）暴露于空气污染的差异， 农村性，占农村形式的变化;和3）估计之间的关联差异 暴露于空气污染或天气和健康的非常年轻（不利的出生结果）和老年人 农村人口（65岁以下者住院），考虑到各种因素的差异 脆弱性因素（社会经济地位低、种族/民族）和农村形式。这些目标将提供一些第一个 关于空气污染、高温和低温如何影响农村社区健康的全面证据，包括 农村形式的差异和脆弱性因素的交叉性，如种族，民族和社会经济地位。

Many populations in rural settings, especially racial and ethnic minority groups, may suffer disproportionate environmental health burdens, such as from air pollution or extreme temperatures. Yet the vast majority of research on environmental health disparities (i.e., “environmental justice”) for air pollution, as well as research on air pollution and health more generally, is conducted for cities. The people, communities, and air pollution sources and mixtures are quite distinct in rural versus urban settings, such that national strategies (i.e., federal regulations) may not be sufficiently protective of health for rural populations. Similarly, research on the health consequences of high and low temperatures, especially for prolonged periods of heat (i.e., “heat waves”), has almost exclusively focused on urban areas. Therefore, current research has major scientific gaps on how the health of rural populations, including rural racial and ethnic minority groups, is impacted by air pollution and extreme temperature. The rural south, particularly the Appalachian region, has higher rates of adverse health outcomes in both older populations (>65y) and infants, compared to national averages. Within the south, rural populations suffer higher rates of multiple morbidities than urban populations, including health outcomes that are linked to air pollution and extreme heat and cold in urban environments. Rural residents also have lower overall income, lower educational attainment, less access to health care, and three years lower life expectancy than their urban counterparts. Evidence suggest that health disparities by race are larger for rural minorities than their urban counterparts. Given the differences in populations, behaviors, environmental hazards, and socioeconomic status (SES), the associations between air pollution, extreme temperature, and health could differ substantially for rural and urban settings. These relationships may also differ across types of rural areas, given the heterogeneity of rural environments. Scientific evidence is urgently needed on the disproportionate impacts of air pollution and extreme temperature in rural environments, with an understanding of the range of rural settings. Our long-term goal is to generate the methods, databases, and scientific estimates that enable knowledge to protect health in rural populations. We propose to: 1) generate a data architecture for air pollution, heat, cold, health, SES, rural form, and other factors in Virginia and West Virginia; 2) estimate disparities in exposure to air pollution and weather (cold, heat, and heat waves) by race/ethnicity, SES, and rurality, accounting for variations in rural form; and 3) estimate disparities in the associations between exposure to air pollution or weather and health for the very young (adverse birth outcomes) and older populations (hospital admissions for those <65 years) for rural populations, considering differences by various vulnerability factors (low SES, race/ethnicity) and rural form. These aims will provide some of the first comprehensive evidence of how air pollution, heat, and cold impact health in rural communities, including differences by rural form and intersectionality of vulnerability factors, such as race, ethnicity, and SES.