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

农村环境中的许多人口，特别是种族和少数民族群体，可能遭受不成比例的痛苦。 环境健康负担，例如来自空气污染或极端温度的负担。然而，绝大多数人 关于空气污染的环境健康差距(即“环境正义”)的研究以及研究 关于空气污染和健康的更广泛的，是针对城市进行的。人、社区和空气污染 在农村和城市环境中，来源和混合物是相当不同的，因此国家战略(即联邦战略) 条例)可能不能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，特别是长时间的高温(即“热浪”)，对 几乎完全集中在城市地区。因此，目前的研究存在着重大的科学空白，即 农村人口，包括农村种族和少数民族群体的健康受到空气污染和 极端的温度。南部农村地区，特别是阿巴拉契亚地区，健康不良的比率更高。 与全国平均水平相比，老年人口(65岁)和婴儿的结果。在南方，农村 与城市人口相比，人口患多种疾病的比率更高，包括 与空气污染和城市环境中的极端炎热和寒冷有关。农村居民的收入也较低。 总体收入较低，受教育程度较低，获得医疗保健的机会较少，预期寿命减少三年 比他们的城市同行更多。有证据表明，农村少数民族按种族划分的健康差距更大。 比他们的城市同行更多。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关联可能 农村和城市的环境有很大的不同。这些关系在不同类型的农村地区也可能不同， 鉴于农村环境的异质性。迫切需要科学证据来证明不成比例的 空气污染和极端温度对农村环境的影响，了解 乡村环境。我们的长期目标是生成方法、数据库和科学估计，以实现 保护农村人口健康的知识。我们建议：1)为AIR生成数据体系结构 弗吉尼亚州和西弗吉尼亚州的污染、高温、寒冷、健康、社会经济状况、农村形式和其他因素；2)估计 暴露在空气污染和天气(寒冷、炎热和热浪)下的种族/民族、社会经济状况和 乡村，解释了乡村形式的变化；以及3)估计不同国家之间的联系 暴露在空气污染或天气和健康对非常小的(不利的出生结果)和老年人 农村人口(65岁的住院人数)，考虑不同类型的差异 脆弱性因素(社会经济地位低、种族/族裔)和农村形式。这些目标将提供一些第一个 关于空气污染、高温和寒冷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因素的交叉性，如种族、族裔和社会经济地位。

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.