| Today's Managing Health Care Costs Number is 7.3% |
Yesterday's New England Journal of Medicine lead article demonstrates that fine particulate matter and ozone exposure cause excess death even at levels that are less than current guidelines - even as the Trump Administration seeks to eliminate current regulations associated with the Clean Air Act which have helped make our air dramatically cleaner than it was a few decades ago.
The study design is elegant - using virtually all Medicare beneficiaries from 2000-2012 (over 60 million), associating them with residential zip codes, and then associating those zip codes with levels of fine particulate matter and ozone and then correlating with mortality. The main analysis suggested an increased mortality risk of 7.3% for each 10 ยตg of fine particulate matter. They then analyzed this a number of ways (see above) - and each analysis showed a striking relationship that remained linear even well under what is considered acceptable under current regulations.
The findings suggest there may be no threshold of fine particulate matter or ozone that is safe - and that efforts to further reduce air pollution from current levels can save many thousands of lives.
Accompanying editorialists remind us that we learned that smog kills in 1946, when 26 people died of a smog episode in Pennsylvania:
In late October 1948, a dense smog descended over the town of Donora, Pennsylvania. The town was home to a zinc plant and a steel mill, both run by the United States Steel Corporation. Susan Gnora, a 62-year-old resident of Donora, started to gasp and cough as the smog descended. She died the next day. Dr. William Rongaus, a physician and a member of the board of health, went door to door, treating patients for their respiratory symptoms and encouraging them to leave town if they could. Many thousands were ill, and at least 20 people died in one of the worst air-pollution disasters in U.S. history. The Donora tragedy transformed our perception of smog from a nuisance to a potential killer.
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For the weekend, two other health policy must reads from Vox.com
Julia Belluz shows how California has dramatically reduced maternal mortality
Researchers from Harvard TH Chan School of Public Health show the calculations demonstrating that the Better Care Reconciliation Act could cost 228,000 lives over the next decade
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