Spatial Cluster of Air Pollutants and Its Association with Life Expectancy, Age-Specific Mortality Risk, and Cause-Specific Mortality Rate: A County-Level Ecological Study Across the USA

Air pollution has been one of the major threats to public health. The study aimed to determine latent patterns of geographical distribution of health-related air pollutants across the USA and to evaluate real-world cumulative effects of these patterns on public health metrics. It was an ecological study using county-level data on the concentrations of 12 air pollutants over 20 years. Latent class analysis was used to identify the common clusters of life expectancy-associated air pollutants based on their concentration characteristics in the final counties studied (<i>n</i> = 699). Multivariate linear regression analyses were then applied to assess the relationship between the LCA-derived clusters and health measurements with confounding adjustment. We found that PM_2.5 mass, PM₁₀ speciation, and NONO<i>_x</i>NO<i>_y</i> (the reactive nitrogen species) were associated with life expectancy and thus were included in LCA. Among five identified clusters, the one with a more severe pollutant profile was associated with a decreasing life expectancy, an increasing mortality risk among middle-aged and elderly populations (≥45 years), and an increasing mortality rate caused by chronic respiratory conditions, cardiovascular diseases, and neoplasms. Our study brings new perspectives on real-world geographical patterns of air pollution to explain health disparities across the USA.