Associations Between Environmental Quality and Mortality in the Contiguous United States, 2000-2005

Overview

Journal Environ Health Perspect

Date 2016 Oct 8

PMID 27713110

Citations 21

Authors

Yun Jian

Lynne C Messer

Jyotsna S Jagai

Kristen M Rappazzo

Christine L Gray

Shannon C Grabich

Danelle T Lobdell

Affiliations

Soon will be listed here.

Abstract

Background: Assessing cumulative effects of the multiple environmental factors influencing mortality remains a challenging task.

Objectives: This study aimed to examine the associations between cumulative environmental quality and all-cause and leading cause-specific (heart disease, cancer, and stroke) mortality rates.

Methods: We used the overall Environmental Quality Index (EQI) and its five domain indices (air, water, land, built, and sociodemographic) to represent environmental exposure. Associations between the EQI and mortality rates (CDC WONDER) for counties in the contiguous United States ( = 3,109) were investigated using multiple linear regression models and random intercept and random slope hierarchical models. Urbanicity, climate, and a combination of the two were used to explore the spatial patterns in the associations.

Results: We found 1 standard deviation increase in the overall EQI (worse environment) was associated with a mean 3.22% (95% CI: 2.80%, 3.64%) increase in all-cause mortality, a 0.54% (95% CI: -0.17%, 1.25%) increase in heart disease mortality, a 2.71% (95% CI: 2.21%, 3.22%) increase in cancer mortality, and a 2.25% (95% CI: 1.11%, 3.39%) increase in stroke mortality. Among the environmental domains, the associations ranged from -1.27% (95% CI: -1.70%, -0.84%) to 3.37% (95% CI: 2.90%, 3.84%) for all-cause mortality, -2.62% (95% CI: -3.52%, -1.73%) to 4.50% (95% CI: 3.73%, 5.27%) for heart disease mortality, -0.88% (95% CI: -2.12%, 0.36%) to 3.72% (95% CI: 2.38%, 5.06%) for stroke mortality, and -0.68% (95% CI: -1.19%, -0.18%) to 3.01% (95% CI: 2.46%, 3.56%) for cancer mortality. Air had the largest associations with all-cause, heart disease, and cancer mortality, whereas the sociodemographic index had the largest association with stroke mortality. Across the urbanicity gradient, no consistent trend was found. Across climate regions, the associations ranged from 2.29% (95% CI: 1.87%, 2.72%) to 5.30% (95% CI: 4.30%, 6.30%) for overall EQI, and larger associations were generally found in dry areas for both overall EQI and domain indices.

Conclusions: These results suggest that poor environmental quality, particularly poor air quality, was associated with increased mortality and that associations vary by urbanicity and climate region. Citation: Jian Y, Messer LC, Jagai JS, Rappazzo KM, Gray CL, Grabich SC, Lobdell DT. 2017. Associations between environmental quality and mortality in the contiguous United States, 2000-2005. Environ Health Perspect 125:355-362; http://dx.doi.org/10.1289/EHP119.

Citing Articles

Environmental Quality, Extreme Heat, and Healthcare Expenditures.

Becker D Int J Environ Res Public Health. 2024; 21(10).

PMID: 39457295 PMC: 11507527. DOI: 10.3390/ijerph21101322.

Landscape analysis of environmental data sources for linkage with SEER cancer patients database.

Tatalovich Z, Chtourou A, Zhu L, Dellavalle C, Hanson H, Henry K J Natl Cancer Inst Monogr. 2024; 2024(65):132-144.

PMID: 39102880 PMC: 11300022. DOI: 10.1093/jncimonographs/lgae015.

Geospatial Modeling Methods in Epidemiological Kidney Research: An Overview and Practical Example.

Buchalter R, Mohan S, Schold J Kidney Int Rep. 2024; 9(4):807-816.

PMID: 38765574 PMC: 11101776. DOI: 10.1016/j.ekir.2024.01.017.

Cumulative environmental quality is associated with breast cancer incidence differentially by summary stage and urbanicity.

Gearhart-Serna L, Mills B, Hsu H, Fayanju O, Hoffman K, Devi G Sci Rep. 2023; 13(1):20301.

PMID: 37985794 PMC: 10662118. DOI: 10.1038/s41598-023-45693-0.

Is gastroschisis associated with county-level socio-environmental quality during pregnancy?.

Krajewski A, Patel A, Gray C, Messer L, Keeler C, Langlois P Birth Defects Res. 2023; 115(18):1758-1769.

PMID: 37772934 PMC: 10878499. DOI: 10.1002/bdr2.2250.

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