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J Clin Epidemiol. 2019 Apr;108:34-43. doi: 10.1016/j.jclinepi.2018.11.024. Epub 2018 Dec 7.

Racial/ethnic disparities in disease burden and costs related to exposure to endocrine-disrupting chemicals in the United States: an exploratory analysis.

Author information

1
Department of Pediatrics, NYU School of Medicine, New York, NY, USA.
2
Department of Pediatrics, NYU School of Medicine, New York, NY, USA; Department of Environmental Medicine, NYU School of Medicine, New York, NY, USA; Department of Population Health, NYU School of Medicine, New York, NY, USA; NYU Wagner School of Public Service, New York, NY, USA; Department of Nutrition, Food & Public Health, NYU Steinhardt School of Culture, Education and Human Development, New York, NY, USA; NYU College of Global Public Health, New York, NY, USA. Electronic address: leonardo.trasande@nyumc.org.

Abstract

OBJECTIVE:

Studies have documented disparities in exposure to endocrine-disrupting chemicals (EDC), but no studies have investigated potential implications for racial/ethnic disparities in chronic disease and associated costs. Our objective was to examine EDC levels in the US population according to race/ethnicity and to quantify disease burden and associated costs.

STUDY DESIGN AND SETTING:

EDC exposure levels in 2007-2010 were obtained from the National Health and Nutrition Examination Surveys. The associated disease burden and costs for 12 exposure-response relationships were determined for non-Hispanic Whites, non-Hispanic Blacks, Mexican Americans, Other Hispanics, and Other/Multicultural.

RESULTS:

EDC exposure levels and associated burden of disease and costs were higher in non-Hispanic Blacks ($56.8 billion; 16.5% of total costs) and Mexican Americans ($50.1 billion; 14.6%) compared with their proportion of the total population (12.6% and 13.5%, respectively). Associated costs among non-Hispanic whites comprised 52.3% of total costs ($179.8 billion) although they comprise 66.1% of the US population. These disparities are driven by generally higher exposure to persistent pesticides and flame retardants among non-Hispanic blacks and Mexican Americans.

CONCLUSION:

Our estimates suggest that racial/ethnic disparities in chronic diseases in the US may be because of chemical exposures and are an important tool to inform policies that address such disparities.

KEYWORDS:

Disease burden; Economic costs; Endocrine-disrupting chemicals; Neurodevelopment; Obesity; Reproductive health

PMID:
30529005
PMCID:
PMC6455970
[Available on 2020-04-01]
DOI:
10.1016/j.jclinepi.2018.11.024

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