ArticleInternational journal of environmental research and public health2026
Untangling Impacts of Socioeconomic Position, Chronic Disease, and Low-Level PM2.5 Exposure on Mortality Among Native American Medicare Beneficiaries.
Article in International journal of environmental research and public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Ambient fine particulate matter (PM2.5) is associated with increased mortality at concentrations below current regulatory standards. Studies of low-level exposure often rely on large administrative cohorts whose geographic and demographic composition may influence observed associations. In a prior analysis, we observed an association between long-term PM2.5 and all-cause mortality among Native American Medicare beneficiaries living in zip codes within the lowest decile of PM2.5 exposure. The present study, a case-control analysis of 1,713,399 low-PM2.5-exposed beneficiaries enrolled in traditional Medicare during 2015-2016, evaluated whether this association could be explained by geographic context, socioeconomic position (SEP), or baseline health status. We used principal components analysis to summarize area-level SEP indicators and beneficiary-level chronic disease diagnoses. In fully adjusted pooled models, PM2.5 was more strongly associated with mortality among Native American beneficiaries (odds ratio, OR = 1.12 per ug/m
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