Increasing Racial and Ethnic Disparities in Ambient Air Pollution-Attributable Morbidity and Mortality in the United States.

Background: Ambient nitrogen dioxide () and fine particulate matter with aerodynamic diameter () threaten public health in the US, and systemic racism has led to modern-day disparities in the distribution and associated health impacts of these pollutants.

Objectives: Many studies on environmental injustices related to ambient air pollution focus only on disparities in pollutant concentrations or provide only an assessment of pollution or health disparities at a snapshot in time. In this study, we compare injustices in and health burdens, considering health impacts across the entire US; document changing disparities in these health burdens over time (2010-2019); and evaluate how more stringent air quality standards would reduce disparities in health impacts associated with these pollutants.

Methods: Through a health impact assessment, we quantified census tract-level variations in health outcomes attributable to and using health impact functions that combine demographic data from the US Census Bureau; two spatially resolved pollutant datasets, which fuse satellite data with physical and statistical models; and epidemiologically derived relative risk estimates and incidence rates from the Global Burden of Disease study.

Results: Despite overall decreases in the public health damages associated with and , racial and ethnic relative disparities in pediatric asthma and premature mortality have widened in the US during the last decade. Racial relative disparities in premature mortality and pediatric asthma have increased by 16% and 19%, respectively, between 2010 and 2019. Similarly, ethnic relative disparities in premature mortality have increased by 40% and pediatric asthma by 10%.

Discussion: Enacting and attaining more stringent air quality standards for both pollutants could preferentially benefit the most marginalized and minoritized communities by greatly reducing racial and ethnic relative disparities in pollution-attributable health burdens in the US. Our methods provide a semi-observational approach to track changes in disparities in air pollution and associated health burdens across the US. https://doi.org/10.1289/EHP11900.