O'Neill Marie S, Jerrett Michael, Kawachi Ichiro, Levy Jonathan I, Cohen Aaron J, Gouveia Nelson, Wilkinson Paul, Fletcher Tony, Cifuentes Luis, Schwartz Joel
Environmental Epidemiology Program, Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts 02215, USA.
Environ Health Perspect. 2003 Dec;111(16):1861-70. doi: 10.1289/ehp.6334.
The effects of both ambient air pollution and socioeconomic position (SEP) on health are well documented. A limited number of recent studies suggest that SEP may itself play a role in the epidemiology of disease and death associated with exposure to air pollution. Together with evidence that poor and working-class communities are often more exposed to air pollution, these studies have stimulated discussion among scientists, policy makers, and the public about the differential distribution of the health impacts from air pollution. Science and public policy would benefit from additional research that integrates the theory and practice from both air pollution and social epidemiologies to gain a better understanding of this issue. In this article we aim to promote such research by introducing readers to methodologic and conceptual approaches in the fields of air pollution and social epidemiology; by proposing theories and hypotheses about how air pollution and socioeconomic factors may interact to influence health, drawing on studies conducted worldwide; by discussing methodologic issues in the design and analysis of studies to determine whether health effects of exposure to ambient air pollution are modified by SEP; and by proposing specific steps that will advance knowledge in this field, fill information gaps, and apply research results to improve public health in collaboration with affected communities.
环境空气污染和社会经济地位（SEP）对健康的影响已有充分记录。最近的一些研究表明，社会经济地位本身可能在与空气污染暴露相关的疾病和死亡流行病学中发挥作用。再加上有证据表明贫困社区和工人阶级社区往往更容易受到空气污染影响，这些研究引发了科学家、政策制定者和公众对空气污染健康影响差异分布的讨论。将空气污染和社会流行病学的理论与实践相结合的更多研究，将有助于科学和公共政策更好地理解这一问题。在本文中，我们旨在通过向读者介绍空气污染和社会流行病学领域的方法学和概念方法；借鉴全球开展的研究，提出关于空气污染和社会经济因素如何相互作用以影响健康的理论和假设；讨论在研究设计和分析中确定社会经济地位是否会改变环境空气污染暴露对健康影响的方法学问题；以及提出推进该领域知识、填补信息空白并与受影响社区合作应用研究结果以改善公众健康的具体步骤，来推动此类研究。
