title: Air Pollution, Cardiovascular Outcomes, and Social Disadvantage: The Multi-ethnic Study of Atherosclerosis.
abstract: BACKGROUND
  Social factors may enhance health effects of air pollution, yet empirical support is inconsistent. The interaction of social and environmental factors may only be evident with long-term exposures and outcomes that reflect long-term disease development.
  
  
  METHODS
  We used cardiac magnetic resonance imaging data from the Multi-Ethnic Study of Atherosclerosis to assess left-ventricular mass index (LVMI) and left-ventricular ejection fraction (LVEF). We assigned residential concentrations of fine particulate matter (PM2.5), oxides of nitrogen, and nitrogen dioxide in the year 2000 to each participant in 2000 using prediction models. We examined modifying roles of four measures of adversity: race/ethnicity, racial/ethnic residential segregation, and socioeconomic status and psychosocial adversity as composite indices on the association between air pollution and LVMI or LVEF.
  
  
  RESULTS
  Compared with whites, blacks showed a stronger adjusted association between air pollution and LVMI. For example, for each 5 µg/m greater PM2.5 level, whites showed a 1.0 g/m greater LVMI (95% confidence interval = -1.3, 3.1), while blacks showed an additional 4.0 g/m greater LVMI (95% confidence interval = 0.3, 8.2). Results were similar for oxides of nitrogen and nitrogen dioxide with regard to black race and LVMI. However, we found no evidence of a modifying role of other social factors or ethnic groups. Furthermore, we found no evidence of a modifying role for any social factors or racial/ethnic groups on the association between air pollution and LVEF.
  
  
  CONCLUSIONS
  Our results suggest that racial group membership may modify the association between air pollution and cardiovascular disease.
authors.affiliation: From the aUniversity of Michigan, Ann Arbor, MI; bUniversity of Washington, Seattle, WA; cNorthwestern University, Evanston, IL; dUniversity of Wisconsin-Milwaukee, Milwaukee, WI; eColumbia University, New York, NY; and fDrexel University, Philadelphia, PA.
authors.forename: Margaret T
authors.initials: MT
authors.lastname: Hicken
authors.forename: Sara D
authors.initials: SD
authors.lastname: Adar
authors.forename: Anjum
authors.initials: A
authors.lastname: Hajat
authors.forename: Kiarri N
authors.initials: KN
authors.lastname: Kershaw
authors.forename: D Phuong
authors.initials: DP
authors.lastname: Do
authors.forename: R Graham
authors.initials: RG
authors.lastname: Barr
authors.forename: Joel D
authors.initials: JD
authors.lastname: Kaufman
authors.forename: Ana V
authors.initials: AV
authors.lastname: Diez Roux
mesh_terms: D000328:Adult; D000368:Aged; D000393:Air Pollutants / Q000633:toxicity*; D000397:Air Pollution / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D005006:Ethnicity; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000191:economics / Q000208:ethnology / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D052638:Particulate Matter / Q000633:toxicity*; D011204:Poverty Areas; D011610:Psychosocial Deprivation; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000191:economics / Q000208:ethnology / Q000209:etiology*; D035862:Vulnerable Populations; D044465:White People
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter