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Lung Disease & Respiratory Health Center

Air Pollution Raises Elderly Care Costs

Seniors in Polluted Areas More Likely to Seek Treatment
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Nov. 12, 2002 -- Elderly people who live in polluted areas are likely to require more medical attention, especially for respiratory problems, than those who live in cleaner areas. A new study shows that older residents of U.S. cities with the most pollution are nearly 20% more likely to be admitted to a hospital for a respiratory condition that those who live in cities with the least air pollution.

The findings are published in the November/December issue of Health Affairs.

The authors say the link between pollution and health is clear, but few studies have looked broadly at the cost-savings benefits of even minor reductions in air pollutions for large segments of the population, such as the elderly.

The study analyzed millions of Medicare records of seniors between the age of 65 to 84 who lived in one of 183 metropolitan areas with populations of more than 100,000 in the U.S. between 1989 and 1991. Due to data limitations and possible confounding factors, the study focused only on white urban residents in the Medicare database.

Researchers looked at measures of inpatient care, outpatient care, medical admissions, surgical admissions, and respiratory admissions and compared them with air pollution measures for the same period.

They found that areas that had higher levels of air pollution also tended to have higher levels of inpatient and outpatient care utilization compared with less polluted areas. This relation remained significant even when other variables that might affect medical care utilization rates -- like geographic region, population size, racial composition, education level, income, cigarette consumption, and obesity -- were accounted for.

For example, residents of the most polluted areas, such as those in major urban areas in the West, had 7% higher overall inpatient care usage rates and 18% higher overall outpatient care usage rates than those in the least polluted areas, such as the Rocky Mountain region.

Overall, admissions to the hospital for respiratory problems showed a "very strong relation" to pollution, say the authors in a news release. The study found a nearly 20% difference in admissions between low and high pollution areas for respiratory problems.

"This study shows that use of medical care is significantly higher in areas with more pollution and that decreased use of care is an important potential benefit from pollution control," write study authors Victor R. Fuchs, professor emeritus at Stanford University, and Sarah Rosen Franks, a doctoral student at the University of California, Berkeley.

"Thus, pollution control offers an important opportunity for further gains in health and reductions in medical care spending," they conclude.

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