Asthma Disparities: How Pollution in Austin Neighborhoods is Impacting Patients Long-Term

The integration of data on air pollution in Austin, Texas, into statistical models diminished asthma impact disparities which are race or ethnicity-related by around 32%, according to new findings, suggesting that such pollution is connected to disparities as far as emergency room (ER) visits for asthma within Black or Latinx communities.¹

These findings were some of the significant results of research by investigators from Dell Medical School and the College of Natural Sciences at the University of Texas at Austin. The analysis had been conducted to assess the effect of small variations in the air quality of different neighborhoods in the 5-county Austin metro region on asthma-related ER visits.

This research was led by Sarah E Chambliss, research associate for the department of population health at Dell Med.

“We are exploring the connections between the neighborhood environment and lung health so that people can understand the risks they face when they live in places with consistently poor air quality,” Chambliss, the lead study author, said in a statement.²

These recent findings by Chambliss and colleagues came about shortly after the Environmental Protection Agency (EPA) had introduced stricter standards for air quality in the US. The new standards suggest that there are elevated levels of fine particulate matter in Austin which are too high, and they can lead to respiratory problems upon inhalation.³

Chambill and the other investigators conducted this research with the aim of building upon established knowledge regarding air quality issues which can exacerbate asthma symptoms. Specifically, they looked at prolonged exposure to higher air pollution levels that can be seen in specific Austin neighborhoods and their correlation with rates of asthma-associated ER care.

Background and Findings

The investigators noted that Black and Latinx communities are known to be more likely to reside in regions that can have elevated air pollution levels. They also noted the moderate pollution levels which have been observed across the Austin metro area.

The research team implemented an administrative database, defining population-based asthma-related ED visit rates at the census tract level. The team carried out their assessment to look into correlations between these rates and average levels of fine particulate matter (PM2.5), nitrogen dioxide (NO2), coarse particulate matter (PM10), and sulfur dioxide (SO2); as well as demographic composition of the regions in Austin.¹

The investigators’ assessment utilized generalized linear models and also accounted for patients’ socioeconomic status, factors related to housing, and other types of covariates. Additionally, the team evaluated whether the inclusion of pollution exposure data made an effect on the incidence risk ratios (IRR) connected to subjects’ race and ethnicity.

Overall, the research team found that levels of PM2.5, PM10, and SO2 were shown to be individually associated with asthma-related ED visit rates at the census tract level. Additionally, the team’s multi-pollutant models demonstrated independent risks specifically linked with PM10 and SO2.

There was a clear link shown between the rates of asthma-related visits to ERs in census tracts and average air pollution. Examples were coarse particulate matter, fine particulate matter, and sulfur dioxide, and these came from urban sources like dust on roads, diesel exhaust, manufacturing, and pollution in landfills.

Another finding the investigators reported was that neighborhoods that were shown to have heightened pollution levels within the air tended to have a larger proportions of Black or Latinx residents. These disparities noted by the research team highlighted environmental inequalities that could be observed within urban settings.

The team noted that integration of pollution data into statistical models had been shown to diminish race- and ethnicity-related disparities in asthma by as much as 32%, which they determined suggested that exposure to pollution may strongly impact disparities in incidence of asthma-related ER visits.

The investigators concluded that such insights underscore the value and importance of informed public health decisions and strategies. They also noted that such findings highlight the urgency of officials addressing environmental disparities if there is progress to be made in health equity within urban areas.

“These findings underscore the urgent need for targeted interventions to mitigate pollution in neighborhoods with higher asthma burdens, especially where Black and Latinx people live,” Elizabeth Matsui, MD, study co-author and director of the Center for Health & Environment: Education & Research at Dell Med, said in a statement.²

References

1. ^{Chambliss SE, Matsui EC, Zàrate RA, Zigler CM. The Role of Neighborhood Air Pollution in Disparate Racial and Ethnic Asthma Acute Care Use. Am J Respir Crit Care Med. Published online February 27, 2024. doi:10.1164/rccm.202307-1185OC.}
2. ^{Air pollution in Austin neighborhoods linked to asthma disparities, UT study finds. EurekAlert! March 19, 2024. https://www.eurekalert.org/news-releases/1038223. Date accessed: March 26, 2024.}
3. ^{Buchele, Mose. Austin area has dangerously high levels of air pollution, according to new EPA standards. KUT News. February 19, 2024. https://www.kut.org/energy-environment/2024-02-19/austin-area-has-dangerously-high-levels-of-air-pollution-according-to-new-epa-standards. Date accessed: March 25, 2024.}