Disparities in exposure to fine particulate air pollution for people with disabilities in the US.

Although chronic air pollution has been found to be disproportionately distributed with respect to race/ethnicity and socioeconomic status in the US, previous research on social disparities in air pollution exposure has not focused on persons with disabilities (PwDs). This gap is addressed here by conducting the first national-scale study of the relationship between outdoor exposure to fine particulate matter (PM) and disability status in the continental US. Census tract-level data on average annual PM concentrations (2011-2015) were linked with relevant variables from the 2015 American Community Survey five-year estimates. Statistical analyses were based on bivariate and multivariable generalized estimating equations that account for spatial clustering of tracts within counties. Results indicated that the overall percentage of civilian noninstitutionalized persons with a disability and multiple types of disability are higher in neighborhoods with greater PM exposure, after controlling for race/ethnicity, poverty, renter occupancy, older age, population density, and metropolitan status. The percentages of PwDs with cognitive and independent living difficulties indicated stronger positive associations with PM exposure, compared to those with other types of difficulties. These findings represent an important starting point for more detailed research investigations and policy interventions that seek to mitigate disproportionate air pollution exposure for this vulnerable group.