# The role of the social environment in the association between air pollution and cardiovascular disease

> **NIH NIH R21** · UNIVERSITY OF WASHINGTON · 2021 · $251,752

## Abstract

Abstract
Contextual level factors like neighborhood socioeconomic status (NSES) and racial residential segregation
(RRS) are potential confounders that may bias air pollution epidemiology studies. Few studies have
systematically examined the magnitude of confounding by these important contextual factors. To our
knowledge no studies have included RRS as a confounder in air pollution-cardiovascular disease (CVD)
studies. We propose to conduct a systematic assessment of the confounding and synergist roles of SES (both
at the neighborhood and individual levels) and RRS in a unique and robust data source made-up of eight well-
characterized chronic disease cohort studies. Extensive covariate data, consistent and lengthy follow-up of
participants, high quality air pollution exposures and standardized collection of CVD outcomes makes this an
ideal data source within which to conduct this important work. An existing project is underway to harmonize
data across these cohorts. Our aims are to: 1) assess the association between different indicators of SES and
RRS and long-term ambient air pollution exposures cross-sectionally and over time, by developing state-of-the-
art measures of SES and RRS 2) conduct quantitative bias analysis to evaluate the magnitude of confounding
by SES and RRS in the association between long-term air pollution and CVD mortality and events and 3)
examine the joint effects of long-term air pollution and SES and RRS on cardiovascular events and mortality.
We will create a time-varying NSES index from principal components analysis for the time period 1990 - 2015
and measures of evenness (dissimilarity index) and isolation (isolation index) to evaluate RRS. We will use
spatial regression approaches for aim 1, probabilistic quantitative bias analysis for aim 2 and survival analysis
for aim 3. The public health impact of this proposal is three-fold. First, evaluating the magnitude of confounding
by SES in air pollution epidemiology studies will strengthen the evidence used for national air pollution
standards. Second, exploration of RRS could establish a new contextual confounder for air pollution
epidemiology. And third, developing a rigorous and strongly theoretically grounded framework for assessing
multiple spatially varying factors will help us better understand longstanding environmental health disparities
and may help design future interventions and policy.

## Key facts

- **NIH application ID:** 10284896
- **Project number:** 1R21ES033343-01
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Anjum Hajat
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $251,752
- **Award type:** 1
- **Project period:** 2021-08-03 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10284896

## Citation

> US National Institutes of Health, RePORTER application 10284896, The role of the social environment in the association between air pollution and cardiovascular disease (1R21ES033343-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10284896. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*