Assessing the Distribution of Air Pollution Health Risks within Cities: A Neighborhood-Scale Analysis Leveraging High-Resolution Data Sets in the Bay Area, California

BACKGROUND: Air pollution-attributable disease burdens reported at global, country, state, or county levels mask potential smaller-scale geographic heterogeneity driven by variation in pollution levels and disease rates. Capturing within-city variation in air pollution health impacts is now possible with high-resolution pollutant concentrations. OBJECTIVES: We quantified neighborhood-level variation in air pollution health risks, comparing results from highly spatially resolved pollutant and disease rate data sets available for the Bay Area, California. METHODS: We estimated mortality and morbidity attributable to nitrogen dioxide ([Formula: see text]), black carbon (BC), and fine particulate matter [PM [Formula: see text] in aerodynamic diameter ([Formula: see text])] using epidemiologically derived health impact functions. We compared geographic distributions of pollution-attributable risk estimates using concentrations from a) mobile monitoring of [Formula: see text] and BC; and b) models predicting annual [Formula: see text] , BC and [Formula: see text] concentrations from land-use variables and satellite observations. We also compared results using county vs. census block group (CBG) disease rates. RESULTS: Estimated pollution-attributable deaths per 100,000 people at the [Formula: see text] grid-cell level ranged across the Bay Area by a factor of 38, 4, and 5 for [Formula: see text] [[Formula: see text] (95% CI: 9, 50)], BC [[Formula: see text] (95% CI: 1, 2)], and [Formula: see text] , [[Formula: see text] (95% CI: 33, 64)]. Applying concentrations from mobile monitoring and land-use regression (LUR) models in Oakland neighborhoods yielded similar spatial patterns of estimated grid-cell–level [Formula: see text] mortality rates. Mobile monitoring concentrations captured more heterogeneity [mobile monitoring [Formula: see text] (95% CI: 19, 107) deaths per 100,000 people; [Formula: see text] (95% CI: 30, 167)]. Using CBG-level disease rates instead of county-level disease rates resulted in 15% larger attributable mortality rates for both [Formula: see text] and [Formula: see text] , with more spatial heterogeneity at the grid-cell–level [[Formula: see text] CBG [Formula: see text] deaths per 100,000 people (95% CI: 12, 68); [Formula: see text] [Formula: see text] (95% CI: 11, 64); [Formula: see text] [Formula: see text] (95% CI: 40, 77); and [Formula: see text] [Formula: see text] (95% CI: 37, 71)]. DISCUSSION: Air pollutant-attributable health burdens varied substantially between neighborhoods, driven by spatial variation in pollutant concentrations and disease rates. https://doi.org/10.1289/EHP7679