Racial/ethnic disparities in PM-attributable cardiovascular mortality burden in the United States.

Average ambient fine particulate matter (PM) concentrations have decreased in the US in recent years, but the health benefits of this improvement among different racial/ethnic groups are unknown. We estimate the associations between long-term exposure to ambient PM and cause-specific cardiovascular disease (CVD) mortality rate and assess the PM-attributable CVD deaths by race/ethnicity across 3,103 US counties during 2001-2016 (n = 595,776 county-months). A 1 µg m increase in PM concentration was associated with increases of 7.16 (95% confidence interval (CI): 3.81, 10.51) CVD deaths per 1,000,000 Black people per month, significantly higher than the estimates for non-Hispanic white people (1.76 (95% CI: 1.37, 2.15); difference in coefficients: 5.40 (95% CI: 2.03, 8.77), P = 0.001). No significant difference in this association was observed between Hispanic (2.66 (95% CI: -0.03, 5.35)) and non-Hispanic white people (difference in coefficients: 0.90 (95% CI: -1.81, 3.61), P = 0.523). From 2001 to 2016, the absolute disparity in PM-attributable CVD mortality burden was reduced by 44.04% between non-Hispanic Black and white people and by 2.61% between Hispanic and non-Hispanic white people. However, in 2016, the burden remained 3.47 times higher for non-Hispanic Black people and 0.45 times higher for Hispanic people than for non-Hispanic white people. We call for policies that aim to reduce both exposure and vulnerability to PM for racial/ethnic minorities.