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Racial/ethnic disparities in disease burden and costs related to exposure to endocrine-disrupting chemicals in the United States: an exploratory analysis

  • Teresa M. Attina
    Affiliations
    Department of Pediatrics, NYU School of Medicine, New York, NY, USA
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  • Julia Malits
    Affiliations
    Department of Pediatrics, NYU School of Medicine, New York, NY, USA
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  • Mrudula Naidu
    Affiliations
    Department of Pediatrics, NYU School of Medicine, New York, NY, USA
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  • Leonardo Trasande
    Correspondence
    Corresponding author. Associate Professor, Department of Pediatrics, New York University School of Medicine, 403 East 34th Street, New York, NY 10016, USA. Tel.: +1-646-501-2520; fax: +1-646-754-9688.
    Affiliations
    Department of Pediatrics, NYU School of Medicine, New York, NY, USA

    Department of Environmental Medicine, NYU School of Medicine, New York, NY, USA

    Department of Population Health, NYU School of Medicine, New York, NY, USA

    NYU Wagner School of Public Service, New York, NY, USA

    Department of Nutrition, Food & Public Health, NYU Steinhardt School of Culture, Education and Human Development, New York, NY, USA

    NYU College of Global Public Health, New York, NY, USA
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Published:December 07, 2018DOI:https://doi.org/10.1016/j.jclinepi.2018.11.024

      Abstract

      Objective

      Studies have documented disparities in exposure to endocrine-disrupting chemicals (EDC), but no studies have investigated potential implications for racial/ethnic disparities in chronic disease and associated costs. Our objective was to examine EDC levels in the US population according to race/ethnicity and to quantify disease burden and associated costs.

      Study Design and Setting

      EDC exposure levels in 2007–2010 were obtained from the National Health and Nutrition Examination Surveys. The associated disease burden and costs for 12 exposure–response relationships were determined for non-Hispanic Whites, non-Hispanic Blacks, Mexican Americans, Other Hispanics, and Other/Multicultural.

      Results

      EDC exposure levels and associated burden of disease and costs were higher in non-Hispanic Blacks ($56.8 billion; 16.5% of total costs) and Mexican Americans ($50.1 billion; 14.6%) compared with their proportion of the total population (12.6% and 13.5%, respectively). Associated costs among non-Hispanic whites comprised 52.3% of total costs ($179.8 billion) although they comprise 66.1% of the US population. These disparities are driven by generally higher exposure to persistent pesticides and flame retardants among non-Hispanic blacks and Mexican Americans.

      Conclusion

      Our estimates suggest that racial/ethnic disparities in chronic diseases in the US may be because of chemical exposures and are an important tool to inform policies that address such disparities.

      Keywords

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