Author + information
- Graham H. Bevan,
- Sanjay Rajagopalan and
- Sadeer Al-Kindi
Air pollution and socioeconomic status have been associated with cardiovascular disease. We sought to study whether socioeconomic status modifies the association between fine particulate matter air pollution (PM2.5) and cardiovascular mortality (CVM).
We linked county-level age-adjusted CVM data from Multiple Cause of Death files (1999-2017, ICD10: I00-I99) with Social Deprivation Index (SDI), a validated estimate of socioeconomic status, and modelled PM2.5 annual exposures. Counties were divided into 4 groups by SDI score (1-25, 26-50, 51-75, 76-100) and associations between PM2.5 and age-adjusted CVM (square-root transformed) were estimated using linear models.
A total of 16,110,048 deaths were analyzed across 3,138 U.S. counties. There was a linear relationship between SDI and CVM, and between PM2.5 and CVM. Both PM2.5 (β 0.26 [0.24-0.28], P<0.001) and SDI scores (β 0.029 [0.027-0.031], P<0.001) were independently associated with age-adjusted CVM (adjusted R2=0.43). The association between PM2.5 and CVM was stronger among counties with highest SDI (β 0.40 [0.33-0.47]) compared with lowest SDI (β 0.24 [0.21-0.27]), P for interaction <0.001, figure.
Social deprivation and PM2.5 exposures were independently associated with county level age-adjusted CVM. The associations between PM2.5 and CVM were stronger in counties with high vs low social deprivation. SDI and PM2.5 explained 43% of the variation in county-level CVM.
Oral Contributions Room S402b
Monday, March 30, 2020, 9:17 a.m.-9:27 a.m.
Session Title: Highlighted Original Research: Prevention and the Year in Review
Abstract Category: 32. Prevention: Clinical
Presentation Number: 913-14
- 2020 American College of Cardiology Foundation