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

Abstract 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.