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 (n = 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.
journal_name
Environ Health Perspectjournal_title
Environmental health perspectivesauthors
Jian Y,Messer LC,Jagai JS,Rappazzo KM,Gray CL,Grabich SC,Lobdell DTdoi
10.1289/EHP119subject
Has Abstractpub_date
2017-03-01 00:00:00pages
355-362issue
3eissn
0091-6765issn
1552-9924pii
EHP119journal_volume
125pub_type
杂志文章abstract::Until recently, mutagenicity testing was done on preselected compounds in a manner in which the testing laboratories knew the identity of the substances under test and the "expected" results, i.e., positive for compounds selected because of their carcinogenicity and negative for food additives. There is no completed s...
journal_title:Environmental health perspectives
pub_type: 杂志文章
doi:10.1289/ehp.7720253
更新日期:1977-10-01 00:00:00
abstract::In this paper, we report results of the second phase of a larger study designed to evaluate the effects on the immune system of living near a Superfund site containing organochlorine pesticides, volatile organic compounds, and metals. Phase II was conducted to determine whether living near the site, consisting of six ...
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journal_title:Environmental health perspectives
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journal_title:Environmental health perspectives
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journal_title:Environmental health perspectives
pub_type: 杂志文章
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更新日期:1990-03-01 00:00:00
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doi:10.1289/ehp.9087233
更新日期:1990-07-01 00:00:00
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journal_title:Environmental health perspectives
pub_type: 杂志文章
doi:10.1289/ehp.00108853
更新日期:2000-09-01 00:00:00
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pub_type: 临床试验,杂志文章
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journal_title:Environmental health perspectives
pub_type: 杂志文章
doi:10.1289/ehp.9086107
更新日期:1990-06-01 00:00:00
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pub_type: 杂志文章
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更新日期:2004-12-01 00:00:00
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journal_title:Environmental health perspectives
pub_type: 杂志文章
doi:10.1289/ehp.939957
更新日期:1993-03-01 00:00:00
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doi:10.1289/ehp.898377
更新日期:1989-11-01 00:00:00
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journal_title:Environmental health perspectives
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更新日期:2010-03-01 00:00:00
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pub_type: 杂志文章
doi:10.1289/ehp.0800193
更新日期:2009-07-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:1990-08-01 00:00:00
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更新日期:1987-06-01 00:00:00
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更新日期:1997-06-01 00:00:00
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更新日期:1996-04-01 00:00:00
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更新日期:1992-07-01 00:00:00
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journal_title:Environmental health perspectives
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doi:10.1289/ehp.00108983
更新日期:2000-10-01 00:00:00
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journal_title:Environmental health perspectives
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更新日期:1987-10-01 00:00:00
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pub_type: 杂志文章
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更新日期:2002-12-01 00:00:00
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journal_title:Environmental health perspectives
pub_type: 杂志文章
doi:10.1289/ehp.99107489
更新日期:1999-06-01 00:00:00