title: Are associations between socio-economic characteristics and exposure to air pollution a question of study area size? An example from Scania, Sweden.
abstract: BACKGROUND
  Numerous studies have shown that exposure to air pollutants in the area of residence and the socio-economic status of an individual may be related. Therefore, when conducting an epidemiological study on the health effect of air pollution, socio-economy may act as a confounding factor. In this paper we examine to what extent socio-economic status and concentrations of NO2 in the county/region of Scania, southern Sweden, are associated and if such associations between these factors differ when studying them at county or city level. To perform this study we used high-resolution census data and modelled the annual exposure to NO2 using an emission database, a dispersion modelling program and a geographical information system (GIS).
  
  
  RESULTS
  The results from this study confirm that socio-economic status and the levels of NO2 in the area of residence are associated in some cities. The associations vary considerably between cities within the same county (Scania). Even for cities of similar sizes and population bases the associations observed are different. Studying the cities together or separately yields contradictory results, especially when education is used as a socio-economic indicator.
  
  
  CONCLUSIONS
  Four conclusions have been drawn from the results of this study. 1) Adjusting for socio-economy is important when investigating the health effects of air pollution. 2) The county of Scania seems to be heterogeneous regarding the association between air pollution and socio-economy. 3) The relationship between air pollution and socio-economy differs in the five cities included in our study, depending on whether they are analysed separately or together. It is therefore inadvisable to determine and analyse associations between socio-economy and exposure to air pollutants on county level. This study indicates that the size and choice of study area is of great importance. 4) The selection of socio-economic indices (in this study: country of birth and education level) is important.
authors.affiliation: GIS Centre & The Department of Physical Geography and Ecosystem Analysis, Lund University, Sölvegatan 12, SE-223 62 Lund, Sweden. emilie.stroh@giscentrum.lu.se
authors.forename: Emilie
authors.initials: E
authors.lastname: Stroh
authors.forename: Anna
authors.initials: A
authors.lastname: Oudin
authors.forename: Susanna
authors.initials: S
authors.lastname: Gustafsson
authors.forename: Petter
authors.initials: P
authors.lastname: Pilesjö
authors.forename: Lars
authors.initials: L
authors.lastname: Harrie
authors.forename: Ulf
authors.initials: U
authors.lastname: Strömberg
authors.forename: Kristina
authors.initials: K
authors.lastname: Jakobsson