This study examines race- and income-based disparities in cancer risks from air toxics in Cancer Alley, LA, USA. Risk estimates were obtained from the 2005 National Air Toxics Assessment and socioeconomic and race data from the 2005 American Community Survey, both at the census tract level. Disparities were assessed using spatially weighted ordinary least squares (OLS) regression and quantile regression (QR) for five major air toxics, each with cancer risk greater than 10⁻⁶. Spatial OLS results showed that disparities in cancer risks were significant: People in low-income tracts bore a cumulative risk 12% more than those in high-income tracts (p < 0.05), and those in black-dominant areas 16% more than in white-dominant areas (p < 0.01). Formaldehyde and benzene were the two largest contributors to the disparities. Contributions from emission sources to disparities varied by compound. Spatial QR analyses showed that magnitude of disparity became larger at the high end of exposure range, indicating worsened disparity in the poorest and most highly concentrated black areas. Cancer risk of air toxics not only disproportionately affects socioeconomically disadvantaged and racial minority communities, but there is a gradient effect within these groups with poorer and higher minority concentrated segments being more affected than their counterparts. Risk reduction strategies should target emission sources, risk driver chemicals, and especially the disadvantaged neighborhoods.

Geographic disparities in mortality have been analyzed by place in myriad ways. Although the people who live in a place continuously change, the health characteristics of those places tend to stay the same; they are persistent. Our work analyzes persistenc

We examined the relationship between race-specific rural mortality and the health infrastructure of rural counties in light of America's recent emergence of a rural mortality penalty. Using the Compressed Mortality File from National Center for Health Statistics (2008-2012) and county-level demographic, socioeconomic, and health care indicators from the Area Health Resource File and the US Census, we created a rural public health infrastructure index which encompasses four types of health care access (public health employees, critical access hospital/rural referral centers, rural health clinics, and emergency departments) within counties. We found that each unit increase in the index is associated with a decline in rural Black mortality, but is associated with an increase in rural White mortality. Policymakers could benefit from focusing on the declining rate of mortality improvement in many rural regions, specifically by trying to better understand how decisions concerning public health spending may influence mortality differently for Black and White residents.

African Americans in the U.S. often live in poverty and segregated urban neighborhoods, many of which have dense industrial facilities resulting in high exposure to harmful air toxics. This study aims to explore the relationship between racial composition and cancer risks from air toxics exposure in Memphis/Shelby County, Tennessee, U.S.A. Air toxics data were obtained from 2005 National Air Toxics Assessment (NATA), and the demographic data, including racial composition, were extracted from the 2000 United States Census. The association was examined using multivariable geographically weighted regression (GWR) analysis. The risk difference between African American and White concentrated areas was defined as the absolute disparity, and the percent difference as the relative disparity. GWR analyses show that cancer risks increase with respect to increasing percent of African Americans at the census tract level. Individuals in African American concentrated tracts bear 6% more cancer risk burden than in White concentrated tracts. The distribution of major roads causes the largest absolute disparity and the distribution of industrial facilities causes the largest relative disparity. Effective strategies for reduction in environmental disparity should especially target sources of large absolute disparities.

Background: In the U.S., inequality is widespread and still growing at nearly every level conceivable. This is vividly illustrated in the long-standing, well-documented inequalities in outcomes between rural and urban places in the U.S.; namely, the rural mortality penalty of disproportionately higher mortality rates in these areas. But what does the concept of “rural” capture and conjure? How we explain these geographic differences has spanned modes of place measurement and definitions. We employ three county-level rural-urban definitions to (1) analyze how spatially specific and robust rural disparities in mortality are and (2) identify whether mortality outcomes are dependent on different definitions.Methods: We compare place-based all-cause mortality rates using three typologies of “rural” from the literature to assess robustness of mortality rates across these rural and urban distinctions. Results show longitudinal all-cause mortality rate trends from 1968 to 2020 for various categories of urban and rural areas. We then apply this data to rural and urban geography to analyze the similarity in the distribution of spatial clusters and outliers in mortality using spatial autocorrelation methodologies.Results: The rural disadvantage in mortality is remarkably consistent regardless of which rural-urban classification scheme is utilized, suggesting the overall pattern of rural disadvantage is robust to any definition. Further, the spatial association between rurality and high rates of mortality is statistically significant.Conclusion: Different definitions yielding strongly similar results suggests robustness of rurality and consequential insights for actionable policy development and implementation.