Exploring the joint effect of atmospheric pollution and socioeconomic status on selected health outcomes: an overview of the PAISARC project

摘要

Health socioeconomic gradients are well documented in developed countries, but incompletely explained. A portion of these health inequalities may be explained by environmental exposures. The objective of PAISARC is to explore the relations between socioeconomic status, air pollution exposure and two selected health outcomes—asthma exacerbations and myocardial infarction—at the level of a small area. The study design is ecological, using data available from the national census, with the residential block (French IRIS, 2000 people on average, National Institute of Statistics—INSEE) as the statistical unit. The setting is the Greater Strasbourg metropolitan area (450?000 inhabitants) in eastern France. We first constructed a socioeconomic status index, using 1999 national census data and principal component analysis at the resolution of these census blocks. Air pollution data were then modeled at the same resolution on an hourly basis for the entire study period (2000–2005). Health data were obtained from various sources (local emergency networks, the local population-based coronary heart disease registry, health insurance funds) according to the health outcome. We present here the initial results and discuss the methodological approaches best suited for the forthcoming steps of our project.