Project 1

 study was published in the New England Journal of Medicine by CRESSH Project 1 collaborators titled “Air Pollution and Mortality in the Medicare Population.” The nationwide cohort study included 61 million Medicare patients from 2000-2012. The study found that long-term exposure to fine particulate matter (particles less than 2.5 μm in diameter) increases the risk of premature mortality at concentrations lower than the current EPA National Ambient Air Quality Standards (NAAQS). The inclusion of the entire Medicare cohort also allowed for extremely accurate subgroup analyses which showed the highest estimated risk of death from fine particulate matter exposure among male, black, and low-income persons. The study was highlighted in an article on the NPR website and was also featured on NPR’s All Things Considered, which included commentary from Project 1 investigator Francesca Dominici. Read the paper here.

The CRESSH Project 1 (HEAL) team published a study in the September 2017 issue ofEpidemiology. The paper titled “Ambient Temperature and Sudden Infant Death Syndrome in the United States” characterizes the association between ambient temperature and Sudden Infant Death Syndrome by analyzing individual-level infant mortality data and outdoor temperature data across the United States.

Sudden Infant Death Syndrome (SIDS) is defined as the unexplained sudden death of an infant less than 1 year old. SIDS is the leading cause of death for infants 1 month to 1 year old and is the third leading cause of overall infant mortality in the US. The rate of SIDS in Massachusetts is greater among black and Hispanic infants than in non-Hispanic white infants. These racial and ethnic disparities in SIDS are of particular concern to CRESSH investigators, who aim to address disparities in health outcomes through their research. While the cause of SIDS is still unknown, overheated bedrooms are known to increase risk due to the limited capabilities of infants to regulate their own body temperature. Because of this, air conditioners as well as good ventilation and airflow in the bedroom can help keep infants from overheating and reduce their risk of SIDS.

To further evaluate the association between ambient temperature and SIDS, Project 1 researchers conducted a national study using infant mortality data from the National Center for Health Statistics and temperature data from the National Oceanic and Atmospheric Administration from 1972-2006 for 210 US cities. They found that the association between temperature and SIDS was highest during the summer among infants 3-11 months old. When the researchers examined racial differences in temperature-related SIDS risk, they found that the percentage increase in SIDS per 10°F increase in ambient temperature was significantly greater among black infants (18.5%) than among white infants (3.6%). The root cause of these racial disparities remains to be determined, but the findings clearly reinforce the need to address SIDS as an environmental health disparities issue and to consider aspects of the home environment that can influence thermal comfort. Overall, these findings indicate that future temperature rises and increased frequency and intensity of heat waves due to climate change may impact infant health. Infants who live in environmental justice communities may be disproportionately impacted by temperature-related health outcomes such as SIDS.

The paper was co-authored by HSPH post-doctoral fellow Iny Jhun, Antonella Zanobetti (Project 1 Lead), Joel Schwartz (Project 1 co-investigator), and colleagues. Read it here.

Project 3

A study published in Environmental Research by CRESSH MAP-EHD (Project 3) researchers found that despite overall decreases in air pollution, exposure inequalities still persist in Massachusetts. The study, titled “Temporal trends in air pollution exposure inequality in Massachusetts,” used modeled PM2.5 and NO2 concentrations as well as U.S. Census data over an eight year period to look at the drivers and trends of exposure inequality over time. The researchers found the greatest inequalities in air pollution exposure among racial/ethnic groups, with non-Hispanic black and Hispanic populations experiencing disproportionately high concentrations. These disparities were more pronounced in urban areas, potentially due to increased segregation. The ability to examine these inequalities longitudinally allowed for a more in depth look at disparities in air pollution exposure, which may provide future insights into how changes in sociodemographic factors over time may influence things like land-use decisions, policy enforcement, or other factors that impact emissions and pollutant concentrations in different areas. This study was featured in an article by the BU School of Public Health, who also created a video highlighting the study’s findings.

Related Readings

Project 1: HEAL

PM2.5 and Mortality in 207 US Cities: Modification by Temperature and City Characteristics

Summer Temperature Variability and Long-Term Survival Among Elderly People with Chronic Disease

Susceptibility to Mortality in Weather Extremes Effect Modification by Personal and Small-Area Characteristics

A National Case-Crossover Analysis of the Short-Term Effect of PM2.5 on Hospitalizations and Mortality in Subjects with Diabetes and Neurological Disorders

Changing Patterns of the Temperature-Mortality Association by Time and Location in the US, and Implications for Climate Change

Project 2: HOME

Moving Environmental Justice Indoors: Understanding Structural Influences on Residential Exposure Patterns in Low-income Communities

Environmental Conditions in Low-Income Urban Housing: Clustering and Associations With Self-Reported Health

Indoor Air Quality in Green vs. Conventional Multi-family Low-income Housing

Project 3: MAP-EHD

Incorporating concepts of inequality and inequity into health benefits analysis

Community Engagement

A Walk in the Park: The Influence of Urban Parks and Community Violence on Physical Activity in Chelsea, MA

Meeting People Where They Are: Engaging Public Housing Residents for Integrated Pest Management

Engaging Communities in Research on Cumulative Risk and Social Stress-Environment Interactions: Lessons Learned from EPA’s STAR Program