Until November 12, 2002

For more information, contact:
Linda Loranger or Janet Firshein, (301) 652-1558

Jon Gardner, Health Affairs
(301) 656-7401, ext. 230


Analysis Involving Millions Of Medicare Records Finds That High Air Pollution Levels
Increase Use Of Outpatient Care And Respiratory Hospital Admissions
By Nearly 20 Percent


WASHINGTON, DC–The largest study ever conducted linking air pollution with medical care found that better pollution control would greatly reduce medical care use and save more than a billion dollars a year in health care spending.

The study, published today in the journal Health Affairs, involved an analysis of millions of Medicare records and showed that air pollution significantly increases the use of medical care among older adults - even after controlling for region, population size, education, income, racial composition, cigarette consumption, and obesity.

Estimating medical care use in 37 areas of the country with the highest levels of air pollution and 37 areas of the country with the lowest levels of air pollution, the study researchers found that, on average:

• Respiratory admissions and use of outpatient care were nearly 20 percent higher in the most polluted areas;
• Medical admissions were 10 percent higher;
• Use of inpatient care was 7 percent higher.

"These results demonstrate that reducing air pollution would have a significant impact on our nation's health care spending," said lead study author Victor R. Fuchs, Henry J. Kaiser Jr. Professor Emeritus at Stanford University.

If anything, the researchers suggest, "inevitable errors" in air pollution measurement probably result in an underestimate of its effect on medical care use.

The study explored geographic differences in medical care use and air pollution using data on 183 metropolitan areas from both Medicare and the Environmental Protection Agency. Measures of inpatient care, outpatient care, medical admissions, surgical admissions, and respiratory admissions for white Medicare beneficiaries ages 65 to 84 were compared with air pollution measures for the same areas from 1989 to 1991.

Only surgical admissions were not significantly related to air pollution levels after control variables were taken into account, the researchers found.

Not surprisingly, the researchers also found that both medical care use and air pollution increase as the population of a given area increases. Air pollution is greatest in the West and lowest in Florida and in the West North Central and Northern Mountain states.

The study researchers noted that although air pollution levels fell somewhat in the 1990s, medical care use nevertheless increased because of the introduction and diffusion of new health care technologies.

"This study shows that air pollution increases use of medical care. Other studies have shown that it increases mortality," Fuchs said. "Both results are important in calculating the benefits of pollution reduction."

Fuchs co-authored the study with Sarah Rosen Frank, a research assistant at the National Bureau of Economic Research, and now a doctoral student in economics at the University of California, Berkeley.

Health Affairs, published by Project HOPE, is a bimonthly multidisciplinary journal devoted to publishing the leading edge in health policy thought and research. Copies of the November/December 2002 issue will be provided free to interested members of the press. Address inquiries to Jon Gardner at Health Affairs, 301-656-7401, ext. 230, or via email, press@healthaffairs.org. Selected articles from the November/December issue are available free on the journal's Web site, www.healthaffairs.org.


©2002 Project HOPE–The People-to-People Health Foundation, Inc.