Abstract Background Environmental disparities may underlie the unequal distribution of health across socioeconomic groups. However, this assertion has not been tested across a range of countries: an important knowledge gap for a transboundary health issue such as air pollution. We consider whether populations of low-income European regions were a) exposed to disproportionately high levels of particulate air pollution (PM 10 ) and/or b) disproportionately susceptible to pollution-related mortality effects. Methods Europe-wide gridded PM 10 and population distribution data were used to calculate population-weighted average PM 10 concentrations for 268 sub-national regions (NUTS level 2 regions) for the period 2004–2008. The data were mapped, and patterning by mean household income was assessed statistically. Ordinary least squares regression was used to model the association between PM 10 and cause-specific mortality, after adjusting for regional-level household income and smoking rates. Results Air quality improved for most regions between 2004 and 2008, although large differences between Eastern and Western regions persisted. Across Europe, PM 10 was correlated with low household income but this association primarily reflected East–West inequalities and was not found when Eastern or Western Europe regions were considered separately. Notably, some of the most polluted regions in Western Europe were also among the richest. PM 10 was more strongly associated with plausibly-related mortality outcomes in Eastern than Western Europe, presumably because of higher ambient concentrations. Populations of lower-income regions appeared more susceptible to the effects of PM 10 , but only for circulatory disease mortality in Eastern Europe and male respiratory mortality in Western Europe. Conclusions Income-related inequalities in exposure to ambient PM 10 may contribute to Europe-wide mortality inequalities, and to those in Eastern but not Western European regions. We found some evidence that lower-income regions were more susceptible to the health effects of PM 10 .
The global prevalence of depression among older adults continues to increase alongside rapid urban development. Scant attention has been paid, however, to how exposure to urbanicity over the life course affects older adults' depressive symptoms, particularly in China, which has undergone substantial recent urbanization. Using data from the China Health and Retirement Longitudinal Study (CHARLS) with its Life History Survey, this study adopts a life-course approach to examine the accumulative and sequenced effects of exposure to urbanicity from 1992 to 2018 on depressive symptoms among older adults, alongside the mediating roles of social relationships. Multilevel regression analysis, clustered at the city level, reveals that higher cumulative exposure to urbanicity is associated with reduced depressive symptoms, particularly with constant or increased exposure to higher levels of urbanicity during middle and older adulthood. This protective effect remains robust against the potential influence of health-selective migration but varies by sex and socioeconomic status. Relationships with friends and neighbors mediate the urbanicity–depression association, whereas cumulative urbanicity exposure is negatively associated with satisfaction with the parent–child relationship and aggregates depressive symptoms. These findings underscore the importance of employing the life-course approach to understand the interplay between health and place across the life span.
As the long‐term negative health effects of continued smoking have become more obvious, smoking cessation has become a key focus of government attention across the developed world. Smoking cessation programmes have had mixed outcomes, with rates of smoking in certain socio‐economically disadvantaged and ethnic minority groups remaining high. The increasing stigmatisation of those who continue to smoke, coupled with the spatial segregation of poor and minority populations, may compound to produce ‘smoking islands’ that may serve to reinforce rather than discourage continued smoking. This paper examines practices of compliance and resistance by disadvantaged smokers and ex‐smokers to strategies of biopower.
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