Department of Pediatrics, NYU School of Medicine, New York, NY, USA.
Department of Pediatrics, NYU School of Medicine, New York, NY, USA; Department of Environmental Medicine, NYU School of Medicine, New York, NY, USA; Department of Population Health, NYU School of Medicine, New York, NY, USA; NYU Wagner School of Public Service, New York, NY, USA; Department of Nutrition, Food & Public Health, NYU Steinhardt School of Culture, Education and Human Development, New York, NY, USA; NYU College of Global Public Health, New York, NY, USA.
J Clin Epidemiol. 2019 Apr;108:34-43. doi: 10.1016/j.jclinepi.2018.11.024. Epub 2018 Dec 7.
Studies have documented disparities in exposure to endocrine-disrupting chemicals (EDC), but no studies have investigated potential implications for racial/ethnic disparities in chronic disease and associated costs. Our objective was to examine EDC levels in the US population according to race/ethnicity and to quantify disease burden and associated costs.
EDC exposure levels in 2007-2010 were obtained from the National Health and Nutrition Examination Surveys. The associated disease burden and costs for 12 exposure-response relationships were determined for non-Hispanic Whites, non-Hispanic Blacks, Mexican Americans, Other Hispanics, and Other/Multicultural.
EDC exposure levels and associated burden of disease and costs were higher in non-Hispanic Blacks ($56.8 billion; 16.5% of total costs) and Mexican Americans ($50.1 billion; 14.6%) compared with their proportion of the total population (12.6% and 13.5%, respectively). Associated costs among non-Hispanic whites comprised 52.3% of total costs ($179.8 billion) although they comprise 66.1% of the US population. These disparities are driven by generally higher exposure to persistent pesticides and flame retardants among non-Hispanic blacks and Mexican Americans.
Our estimates suggest that racial/ethnic disparities in chronic diseases in the US may be because of chemical exposures and are an important tool to inform policies that address such disparities.
已有研究记录了内分泌干扰化学物质(EDC)暴露方面的差异,但尚无研究调查其对慢性疾病和相关成本方面的种族/民族差异的潜在影响。我们的目的是根据种族/民族研究美国人群中 EDC 水平,并量化疾病负担和相关成本。
2007-2010 年 EDC 暴露水平来自国家健康和营养调查。对于非西班牙裔白人、非西班牙裔黑人、墨西哥裔美国人、其他西班牙裔人和其他/多种族人群,确定了 12 种暴露-反应关系的相关疾病负担和成本。
非西班牙裔黑人(568 亿美元;占总成本的 16.5%)和墨西哥裔美国人(501 亿美元;占总成本的 14.6%)的 EDC 暴露水平以及相关疾病负担和成本均高于其在总人口中的比例(分别为 12.6%和 13.5%)。非西班牙裔白种人(523 亿美元,占总成本的 52.3%)的相关成本虽然占美国总人口的 66.1%,但占总成本的 52.3%。这些差异是由非西班牙裔黑人和墨西哥裔美国人普遍更高的持久性杀虫剂和阻燃剂暴露驱动的。
我们的估计表明,美国慢性疾病的种族/民族差异可能是由于化学暴露造成的,这是一个重要的工具,可以为解决这些差异的政策提供信息。