New article "Heat and Air Pollution Shape Divergent Mortality Patterns across Rural and Urban United States"

Shuai Zhou, Chuan Liao, Ziqing Wei, and Guangqing Chi have recently published a paper on the environmental impacts on county-level mortality in the United States in npj Environmental Social Sciences.

In explaining health outcomes, the social determinants of health (SDH) framework is often cited. Indeed, existing research estimates that 40–80% of health outcomes can be attributed to social factors. However, the SDH framework has often overlooked environmental factors, which have been shown to increasingly impact health outcomes. 

By linking mortality data with climate data and sociodemographic factors from 2009 through 2019, Zhou and Chi explored the impacts of temperature, air quality, and their interactions on cause- and age-specific mortality at the county level in the United States. The results reveal an environment-induced rural paradox and urban penalty, alongside the well-documented rural mortality penalty. Specifically, they found that as temperatures and PM2.5 levels increase, rural counties faced a cardiovascular mortality penalty among infants, while a rural paradox emerged in respiratory mortality, with lower respiratory mortality observed in rural counties. Meanwhile, an urban respiratory mortality penalty appeared among working-age adults under increasing temperatures and worsening PM2.5 levels.

Accordingly, addressing health disparities requires context-specific interventions that consider infrastructure, occupational, and behavioral factors. On the one hand, rural areas could benefit from investments in early warning systems for extreme climate conditions, as well as expanded public awareness to promote behavioral adaptations that reduce exposure to harmful environmental conditions. On the other hand, urban areas need to strengthen workplace regulations to mitigate heat and air pollution exposure, protect vulnerable workers, and expand green infrastructure to counteract the harmful effects of extreme temperatures, air pollution, and their reinforcing interactions.

Read the article here: Heat and Air Pollution Shape Divergent Mortality Patterns across Rural and Urban United States