Pollution and inequality (Chapter 6)

Pollution is unequally distributed and contributes to health inequalities. Pollution-related health inequalities exist for various reasons. Pollution sources can be concentrated in particular areas, once in the environment pollution may accumulate and disperse unevenly, and some people can be more susceptible to the health effects of being exposed to pollution than others. There are strong geographical differences in the occurrence and concentration of pollutants. Analysis shows that these patterns, which vary by pollutant type, are related to measures of socioeconomic status, with pollution sources and higher concentrations of ambient pollution typically found in more socially disadvantaged areas. The evidence of how pollution sources and concentrations vary with other socio-demographic variables, including ethnicity, is less substantial and consistent. How unequal patterns of pollution exposure relate to health inequalities is complex. Poor health status, adverse health behaviours, multiple environmental exposures and psychosocial stress are more prevalent in lower socioeconomic groups. These factors may mean that pollution exposure has greater impacts on the health of these groups, a so-called ‘triple jeopardy’ effect. These relationships have been most substantially examined for air quality. UK studies provide tentative evidence of differences in susceptibility affecting health outcomes from air pollution exposure. International studies are more conclusive that these effects exist. Options to intervene in the relationship between pollution and health inequalities include proactive assessment of the distributional effects of plans and policies to inform decision making; targeting measures on ‘pollution-poverty hotspots’; and supporting community involvement in pollution monitoring and mitigation.