收稿日期: 2025-04-09
网络出版日期: 2025-07-02
基金资助
国家自然科学联合基金重点项目(U23A 200012)
The role of socioeconomic status in the relationship between environmental pollution and mortality
Received date: 2025-04-09
Online published: 2025-07-02
目的 本研究旨在评估环境污染与死亡率之间的关系以及社会经济地位（SES）的中介作用。 方法 本研究使用了318 974名英国生物样本库参与者的数据。SES采用汤森剥夺指数（TDI）评估。运用Cox回归模型检验环境污染与全因死亡率、特定原因死亡率的关系，通过线性回归分析TDI与污染在死亡风险中的中介作用。 结果 随访期间共发生24 909例死亡，平均年龄61.5岁。除PM10外，其他污染物均与全因死亡率相关，PM2.5与特定原因死亡率相关。环境污染评分越高，全因死亡率HR越高，最高五分位数组HR为1.13（95% CI：1.09 ~ 1.18）。社会经济剥夺越严重，全因死亡率HR越高，最贫困组HR为1.36（95% CI：1.24 ~ 1.49）。 结论 环境污染是死亡的风险因素，社会经济起一定的中介作用。除了实施公共卫生干预和个人行为指导外，还需通过社会政策创新和财政支持机制，改善贫困地区的整体环境状况。
舒杨 , 陈浩 , Lam Lawrence . 社会经济地位在环境污染与死亡率关系中的作用[J]. 实用医学杂志, 2025 , 41(12) : 1913 -1921 . DOI: 10.3969/j.issn.1006-5725.2025.12.021
Objective To assess the relationship between environmental pollution and mortality， along with the mediating function of socioeconomic status （SES）. Methods Data sourced from the UK Biobank were utilized， encompassing 318，974 participants. SES was evaluated through the Townsend Deprivation Index （TDI）. Cox regression models were employed to explore the associations between environmental pollution and all-cause mortality， as well as cause-specific mortality. Linear regression analysis was conducted to analyze the mediating role of TDI levels in the relationship between pollution and mortality risk. Results During the follow-up period， 24 909 deaths were recorded， with the participants having an average age of 61.5 years. Except for PM10， all pollutants were found to be associated with all-cause mortality， and PM2.5 was linked to cause-specific mortality. Higher pollution scores were correlated with elevated all-cause mortality hazard ratios （HRs）， reaching 1.13 （95%CI： 1.09 ~ 1.18） in the highest quintile. Greater socioeconomic deprivation was also associated with higher all-cause mortality HRs， specifically 1.36 （95%CI： 1.24 ~ 1.49） for the most deprived group. Conclusions Environmental pollution constitutes a risk factor for mortality， with SES playing a mediating role. Besides public health interventions and personal behavioral guidance， innovative social policies and financial support mechanisms are requisite to improve the overall environment in impoverished regions.
Key words： socioeconomic status; environmental pollution; mortality; UK Biobank; public health
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