Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, 722 W 168th St, 11th Floor Rm 1107A, New York, 10032, NY, USA.
Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, 722 W 168th St, 11th Floor Rm 1107A, New York, 10032, NY, USA.
Environ Pollut. 2022 Nov 15;313:120113. doi: 10.1016/j.envpol.2022.120113. Epub 2022 Sep 6.
Inorganic arsenic is a known human carcinogen and is routinely detected in US community water systems (CWSs). Inequalities in CWS arsenic exist across broad sociodemographic subgroups. Our objective was to evaluate the county-level association between socioeconomic vulnerability and CWS arsenic concentrations across the US. We evaluated previously developed, population-weighted CWS arsenic concentrations (2006-2011) and three socioeconomic domains (the proportion of adults with a high school diploma, median household income, and the Centers for Disease Control and Prevention's overall socioeconomic vulnerability score) for 2,604 conterminous US counties. We used spatial lag models and evaluated the adjusted geometric mean ratio (GMR) of CWS arsenic concentrations per higher socioeconomic domain score corresponding to the interquartile range, and also evaluated flexible quadratic spline models. We also stratified by region and by United States Department of Agriculture Rural-Urban Continuum Codes to assess potential effect measure modification by region and rurality. Associations between socioeconomic vulnerability and CWS arsenic were modified by region and rurality and specific to socioeconomic domain. The fully adjusted GMR (95% CIs) of CWS arsenic per interquartile range higher proportion of adults with a high school education was 0.83 (0.71, 0.98) in the Southwest (corresponding to 17% lower arsenic with higher education), 0.82 (0.71, 0.94) in the Eastern Midwest (18% lower), and 0.65 (0.31, 1.36) in New England (35% lower). Associations between median household income and CWS arsenic were largely null. Higher overall socioeconomic vulnerability was significantly associated with lower CWS arsenic, but only in counties in the Central Midwest and those with total populations less than 20,000. Findings may reflect regional/local differences in both socioeconomic/socio-cultural context and public drinking water regulatory efforts. Across the US, individual domains of socioeconomic vulnerability (especially educational attainment) are more strongly associated with inequalities in CWS arsenic than the complex overall socioeconomic vulnerability index.
无机砷是一种已知的人类致癌物，在美国社区供水系统（CWS）中经常被检测到。CWS 中的砷存在于广泛的社会人口统计学亚组之间的不平等现象。我们的目标是评估美国各县的社会经济脆弱性与 CWS 砷浓度之间的县一级关联。我们评估了先前开发的、基于人口权重的 CWS 砷浓度（2006-2011 年）和三个社会经济领域（高中文凭成年人的比例、家庭中位数收入以及疾病控制与预防中心的整体社会经济脆弱性评分），评估了 2604 个美国相邻县。我们使用空间滞后模型和评估了每增加一个社会经济领域得分的 CWS 砷浓度的调整后的几何平均比（GMR），对应于四分位间距，还评估了灵活的二次样条模型。我们还按区域和美国农业部农村-城市连续体代码进行分层，以评估潜在的效应量修正与区域和农村性的关系。社会经济脆弱性与 CWS 砷之间的关联因区域和农村性而异，并且特定于社会经济领域。经过完全调整的 GMR（95%CI），每四分位间距更高的高中教育成年人比例对应的 CWS 砷浓度为 0.83（0.71，0.98），在西南部（对应于砷含量降低 17%），0.82（0.71，0.94）在中西部东部（降低 18%），以及新英格兰地区（降低 35%）的 0.65（0.31，1.36）。家庭中位数收入与 CWS 砷之间的关联在很大程度上是无效的。更高的整体社会经济脆弱性与 CWS 砷浓度显著相关，但仅在中西部中心地区和县的总人口少于 20,000 的县中相关。研究结果可能反映了社会经济/社会文化背景以及公共饮用水监管工作的区域/地方差异。在美国，社会经济脆弱性的个别领域（特别是教育程度）与 CWS 砷浓度的不平等关系更为密切，而不是复杂的整体社会经济脆弱性指数。
