O'Neill Marie S, Kinney Patrick L, Cohen Aaron J
Departments of Epidemiology and Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan 48109, USA.
J Toxicol Environ Health A. 2008;71(9-10):570-7. doi: 10.1080/15287390801997625.
The health burden of environmental exposures, including ambient air pollution and climate-change-related health impacts, is not equally distributed between or within regions and countries. These inequalities are currently receiving increased attention in environmental research as well as enhanced appreciation in environmental policy, where calls for environmental equity are more frequently heard. The World Health Organization (WHO) 2006 Global Update of the Air Quality Guidelines attempted to address the global-scale inequalities in exposures to air pollution and the burden of diseases due to air pollution. The guidelines stop short, however, of addressing explicitly the inequalities in exposure and adverse health effects within countries and urban areas due to differential distribution of sources of air pollution such as motor vehicles and local industry, and differences in susceptibility to the adverse health effects attributed to air pollution. These inequalities, may, however, be addressed in local air quality and land use management decisions. Locally, community-based participatory research can play an important role in documenting potential inequities and fostering corrective action. Research on environmental inequities will also benefit from current efforts to (1) better understand social determinants of health and (2) apply research evidence to reduce health disparities. Similarly, future research and policy action will benefit from stronger linkages between equity concerns related to health consequences of both air pollution exposure and climate change, since combustion products are important contributors to both of these environmental problems.
包括室外空气污染和与气候变化相关的健康影响在内的环境暴露所造成的健康负担，在不同区域和国家之间以及区域和国家内部的分布并不均衡。目前，这些不平等现象在环境研究中受到越来越多的关注，在环境政策中也得到了更多的重视，环境公平的呼声也越来越高。世界卫生组织（WHO）2006年《空气质量准则全球更新》试图解决全球范围内空气污染暴露和空气污染所致疾病负担方面的不平等问题。然而，这些准则并未明确解决因机动车和当地工业等空气污染源分布差异以及对空气污染所致不良健康影响的易感性差异而导致的国家和城市地区内部暴露和不良健康影响的不平等问题。不过，这些不平等问题可以在地方空气质量和土地利用管理决策中得到解决。在地方层面，基于社区的参与性研究可以在记录潜在的不平等现象和促进采取纠正行动方面发挥重要作用。对环境不平等问题的研究也将受益于当前为（1）更好地理解健康的社会决定因素和（2）应用研究证据以减少健康差距所做的努力。同样，未来的研究和政策行动将受益于空气污染暴露和气候变化的健康后果相关公平问题之间更紧密的联系，因为燃烧产物是这两个环境问题的重要成因。
