Academic journal article Environmental Health Perspectives

Separate and Unequal: Residential Segregation and Estimated Cancer Risks Associated with Ambient Air Toxics in U.S. Metropolitan Areas

Academic journal article Environmental Health Perspectives

Separate and Unequal: Residential Segregation and Estimated Cancer Risks Associated with Ambient Air Toxics in U.S. Metropolitan Areas

Article excerpt

This study examines links between racial residential segregation and estimated ambient air toxics exposures and their associated cancer risks using modeled concentration estimates from the U.S. Environmental Protection Agency's National Air Toxics Assessment. We combined pollutant concentration estimates with potencies to calculate cancer risks by census tract for 309 metropolitan areas in the United States. This information was combined with socioeconomic status (SES) measures from the 1990 Census. Estimated cancer risks associated with ambient air toxics were highest in tracts located in metropolitan areas that were highly segregated. Disparities between racial/ethnic groups were also wider in more segregated metropolitan areas. Multivariate modeling showed that, after controlling for tract-level SES measures, increasing segregation amplified the cancer risks associated with ambient air toxics for all racial groups combined [highly segregated areas: relative cancer risk (RCR) = 1.04; 95% confidence interval (CI), 1.01-107; extremely segregated areas: RCR = 1.32; 95% CI, 1.28-1.36]. This segregation effect was strongest for Hispanics (highly segregated areas: RCR = 1.09; 95% CI, 1.01-1.17; extremely segregated areas: RCR = 1.74; 95% CI, 1.61-1.88) and weaker among whites (highly segregated areas: RCR = 1.04; 95% CI, 1.01-1.08; extremely segregated areas: RCR = 1.28; 95% CI, 1.24-1.33), African Americans (highly segregated areas: RCR = 1.09; 95% CI, 0.98-1.21; extremely segregated areas: RCR = 1.38; 95% CI, 1.24-1.53), and Asians (highly segregated areas: RCR = 1.10; 95% CI, 0.97-1.24; extremely segregated areas: RCR = 1.32; 95% CI, 1.16-1.51). Results suggest that disparities associated with ambient air toxics are affected by segregation and that these exposures may have health significance for populations across racial lines. Key words: air toxics, cancer risk, environmental justice, health disparity, racial disparity, segregation. Environ Health Perspect 114:386-393 (2006). doi:10.1289/ehp.8500 available via http://dx.doi.org/[Online 19 October 2005]

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Nearly 80% of the approximately 280 million people living in the United States reside in metropolitan areas (U.S. Bureau of the Census 2004). Environmental health researchers and public health practitioners have recently begun to focus on the links between the urban built environment, social inequality, and community health and well-being (Frumkin 2002, 2003; Jackson 2002; Northridge et al. 2003). Despite the proliferation of research on this issue, there is a lack of scientific consensus about what it is about neighborhood and other area-level variables that affect health. Neighborhood-level factors affect individual health by influencing access to quality foods, especially fresh fruits and vegetables and affordable supermarkets, and access to crucial services, such as health care, parks, and open space (Diez-Roux 2003; Morland et al. 2002; Transportation and Land Use Coalition 2002). Other key neighborhood factors that affect health include the social environment (social capital, cohesion, and crime rates) (Kawachi and Berkman 2003; Wallace and Wallace 1998; Wallace 1988) and the physical environment (traffic density, housing quality, and abandoned properties) (Reynolds et al. 2002; Shenassa et al. 2004; Wallace 1990).

Environmental health researchers, sociologists, policy makers, and advocates concerned about environmental justice have argued that residents of color who are concentrated in neighborhoods with high levels of poverty are also disproportionately exposed to physical environments that adversely affect their health and well-being. Research on race and class differences in exposures to toxics varies widely, and although by no means unequivocal, much of the evidence suggests a pattern of disproportionate exposures to toxics and associated health risks among communities of color and the poor, with racial differences often persisting across economic strata (Burke 1993; Morello-Frosch et al. …

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