title: Estimating causal effects of air quality regulations using principal stratification for spatially correlated multivariate intermediate outcomes.
abstract: Methods for causal inference regarding health effects of air quality regulations are met with unique challenges because (1) changes in air quality are intermediates on the causal pathway between regulation and health, (2) regulations typically affect multiple pollutants on the causal pathway towards health, and (3) regulating a given location can affect pollution at other locations, that is, there is interference between observations. We propose a principal stratification method designed to examine causal effects of a regulation on health that are and are not associated with causal effects of the regulation on air quality. A novel feature of our approach is the accommodation of a continuously scaled multivariate intermediate response vector representing multiple pollutants. Furthermore, we use a spatial hierarchical model for potential pollution concentrations and ultimately use estimates from this model to assess validity of assumptions regarding interference. We apply our method to estimate causal effects of the 1990 Clean Air Act Amendments among approximately 7 million Medicare enrollees living within 6 miles of a pollution monitor.
authors.affiliation: Department of Biostatistics, Harvard University, Harvard School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA. czigler@hsph.harvard.edu
authors.forename: Corwin M
authors.initials: CM
authors.lastname: Zigler
authors.forename: Francesca
authors.initials: F
authors.lastname: Dominici
authors.forename: Yun
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000368:Aged; D000397:Air Pollution / Q000009:adverse effects / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D001499:Bayes Theorem; D056808:Biostatistics / Q000379:methods*; D015984:Causality; D004784:Environmental Monitoring; D062665:Epidemiological Monitoring; D006801:Humans; D016014:Linear Models; D015999:Multivariate Analysis; D011634:Public Health; D014481:United States / Q000453:epidemiology; D014484:United States Environmental Protection Agency / Q000331:legislation & jurisprudence