Air pollution, self-reported health, and ethnicity in the UK: A spatial-temporal analysis

BACKGROUND: Air pollution is associated with poor health; though it is unclear whether this association is stronger for ethnic minorities compared to the population majority. In this study, we assessed the spatial-temporal association between air pollution and self-reported health and its variation by ethnicity in the UK. METHODS: Individual-level data from Understanding Society: the UK Household Longitudinal Study including 67,982 adult individuals over 11 years (2009-2019) were linked to yearly concentrations of NO2, SO2, PM10, and PM2.5 pollutants using the census Lower Super Output Area (LSOA) of residence. The association between air pollution and self-reported health (Likert scale: 1-5, excellent to poor) and its variation by ethnicity was assessed using three-level mixed-effects ordered logistic models. Analysis distinguished between spatial (between areas) and temporal (across time within each area) effects of air pollution. RESULTS: Higher concentrations of NO2, SO2, PM10, and PM2.5 pollution were associated with poorer health. Decomposing air pollution into between (spatial: across LSOAs) and within (temporal: across years within each LSOA) effects showed a significant between effect for NO2, SO2, PM10, and PM2.5 pollutants, while within effects were absent for all pollutants. People from Indian and Pakistani/Bangladeshi origins and non-UK-born individuals reported poorer health with increasing concentrations of SO2, PM10, and PM2.5 pollutants in comparison to British-white and UK-born individuals. CONCLUSIONS: This study supports the presence of a spatial-temporal association between air pollution and poor self-reported health, which is stronger for ethnic minorities and foreign-born individuals in the UK. Air pollution mitigation is necessary to improve individuals’ health, especially for ethnic minorities who are affected the most. KEY MESSAGES: • Exposure to air pollution is linked to poor self-reported health and this association is stronger for ethnic minorities compared to the UK majority population. • Local measures to reduce air pollution, especially in ethnic concentration neighbourhoods are necessary to improve people’s health.