We are all affected by air pollution but some of us suffer a greater burden than others.
An analysis published by the mayor of London has laid out the systematic air pollution differences between communities. Overall, people of black or mixed ethnicities are more likely to live in the most polluted places.
There is ample evidence that air pollution exposure can lead to preterm and low birth-weight babies. Air pollution then hampers children’s lung growth, increases the chance of childhood asthma and worsens asthma symptoms.
Despite this, a new survey by the NGO Global Black Maternal Health has shown a lack of awareness of air pollution risks among expectant black mothers, and those with young children. It also found a need for increased knowledge among the health professionals who care for them.
The survey findings were announced at the Royal College of Obstetricians and Gynaecologists. It found many black mothers were aware of air pollution but less aware of risks that it posed. Some mothers would like to make lifestyle changes to reduce their air pollution exposure but felt they had few options.
Agnes Agyepong, the founder of Global Black Maternal Health and Black Child Clean Air, said: “In the UK, black women are nearly four times more likely to die during pregnancy and experience twice the rate of stillbirth compared with white women. The report aimed to elevate the voices of black women, who are disproportionately exposed to illegal levels of air pollution but largely missing from conversations around clean air.”
There are also important differences in air pollution between the richest and least well-off areas. These differences are not confined to London. Across England, the greatest air pollution is found in the poorest and also in the least white communities. During the first decade of this century, the gap between air pollution in the most and least deprived places got worse, not better.
But looking at the quality of air that we breathe only shows us part of the problem. There is evidence that the least well-off are more vulnerable to air pollution. This includes studies from Italy and the UK.
In 2019, a study on more than 300,000 people in the UK found that lung problems from air pollution were especially pronounced in people with lower income. This included chronic obstructive pulmonary disease (COPD).
Prof Anna Hansell of the University of Leicester, who led the UK lung health study, said: “Worryingly, we found that air pollution had much larger effects on people from lower-income households. Air pollution had approximately twice the impact on lung function decline and three times the increased COPD risk on lower-income participants compared to higher-income participants who had the same air pollution exposure.”
Possible reasons for greater susceptibility to harmful effects of air pollution include more childhood respiratory infections, poorer housing, worse indoor air quality, poor nutrition, and air pollution exposures at work for those with lower incomes.
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A new report from Asthma & Lung UK also highlights worse lung health among the poorest people in the UK.
The poorest people emit least air pollution, but the multiplicative effect of worst concentrations and greater vulnerability means the least well-off bear an unfair proportion of health burden from air pollution.
Attacking health and environmental injustice and inequalities is an urgent priority that will take a generation to address. Tackling the multiplying effect from air pollution could be far faster. In London, the air pollution gap between the most and least deprived showed some decreases between 2013 and 2019, as did the differences between ethnic groups.