ArticleEpidemiology (Cambridge, Mass.)2021
Long-term Exposure to PM2.5 and Mortality for the Older Population: Effect Modification by Residential Greenness.
Article in Epidemiology (Cambridge, Mass.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- "We adjusted for race": now what? A systematic review of utilization and reporting of race in American Journal of Epidemiology and Epidemiology, 2020-2021.Epidemiologic reviews · 2023Pooled it
- Prenatal greenness, air pollution, and birthweight: Assessing sensitive windows of exposure and sub-populations in a multi-exposure setting.Environment international · 2026Article
- Ambient Fine Particulate Matter, Residential Greenness, and Childhood Cancer Risk by Trimester of Exposure in Minnesota 2000 to 2014: A Case-Control Study.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Article
- Low-level PM 2.5 Exposure, Cardiovascular and Nonaccidental Mortality, and Related Health Disparities in 12 US States.Epidemiology (Cambridge, Mass.) · 2025Article
- Global burden of subarachnoid hemorrhage attributable to ambient PMFrontiers in public health · 2025Article
- Short-Term Interaction Effects of PMToxics · 2024Article
- PM2.5, vegetation density, and childhood cancer: a case-control registry-based study from Texas 1995-2011.Journal of the National Cancer Institute · 2024Article
- Ambient fine particulate matter and daily mortality: a comparative analysis of observed and estimated exposure in 347 cities.International journal of epidemiology · 2024Article
- Weekly prenatal PMEnvironmental research · 2024Article
- Satellite data for environmental justice: a scoping review of the literature in the United States.Environmental research letters : ERL [Web site] · 2024Article
- Article
- Methods in Public Health Environmental Justice Research: a Scoping Review from 2018 to 2021.Current environmental health reports · 2023Article
- The impact of GPS-derived activity spaces on personal PMEnvironmental research · 2022Article
- Greenspace and mortality in the U.K. Biobank: Longitudinal cohort analysis of socio-economic, environmental, and biomarker pathways.SSM - population health · 2022Article
- Mortality risk associated with greenness, air pollution, and physical activity in a representative U.S. cohort.The Science of the total environment · 2022Article
- Joint associations between neighborhood walkability, greenness, and particulate air pollution on cardiovascular mortality among adults with a history of stroke or acute myocardial infarction.Environmental epidemiology (Philadelphia, Pa.) · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
backgroundAlthough many studies demonstrated reduced mortality risk with higher greenness, few studies examined the modifying effect of greenness on air pollution-health associations. We evaluated residential greenness as an effect modifier of the association between long-term exposure to fine particles (PM2.5) and mortality.
methodsWe used data from all Medicare beneficiaries in North Carolina (NC) and Michigan (MI) (2001-2016). We estimated annual PM2.5 averages using ensemble prediction models. We estimated mortality risk per 1 μg/m3 increase using Cox proportional hazards modeling, controlling for demographics, Medicaid eligibility, and area-level covariates. We investigated health disparities by greenness using the Normalized Difference Vegetation Index with measures of urbanicity and socioeconomic status.
resultsPM2.5 was positively associated with mortality risk. Hazard ratios (HRs) were 1.12 (95% confidence interval (CI) = 1.12 to 1.13) for NC and 1.01 (95% CI = 1.00 to 1.01) for MI. HRs were higher for rural than urban areas. Within each category of urbanicity, HRs were generally higher in less green areas. For combined disparities, HRs were higher in low greenness or low SES areas, regardless of the other factor. HRs were lowest in high-greenness and high-SES areas for both states.
conclusionsIn our study, those in low SES and high-greenness areas had lower associations between PM2.5 and mortality than those in low SES and low greenness areas. Multiple aspects of disparity factors and their interactions may affect health disparities from air pollution exposures. Findings should be considered in light of uncertainties, such as our use of modeled PM2.5 data, and warrant further investigation.
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