There are large differences in premature mortality in the USA by race/ethnicity, education, rurality and social vulnerability index groups. Using existing concentration–response functions, published particulate matter (PM_2.5) air pollution estimates, population estimates at the census tract level and county-level mortality data from the US National Vital Statistics System, we estimated the degree to which these mortality discrepancies can be attributed to differences in exposure and susceptibility to PM_2.5. We show that differences in PM_2.5-attributable mortality were consistently more pronounced by race/ethnicity than by education, rurality or social vulnerability index, with the Black American population having the highest proportion of deaths attributable to PM_2.5 in all years from 1990 to 2016. Our model estimates that over half of the difference in age-adjusted all-cause mortality between the Black American and non-Hispanic white population was attributable to PM_2.5 in the years 2000 to 2011. This difference decreased only marginally between 2000 and 2015, from 53.4% (95% confidence interval 51.2–55.9%) to 49.9% (95% confidence interval 47.8–52.2%), respectively. Our findings underscore the need for targeted air quality interventions to address environmental health disparities.

在美国，不同种族/族裔、教育程度、农村地区和社会脆弱性指数群体的过早死亡率存在很大差异。利用现有的浓度响应函数、已发布的颗粒物 (PM _2.5 ) 空气污染估计、人口普查区一级的人口估计以及美国国家生命统计系统的县级死亡率数据，我们估计了这些死亡率差异可归因于 PM _2.5 暴露和易感性的差异。我们发现，种族/族裔造成的 PM _2.5 死亡率的差异始终比教育、农村或社会脆弱性指数的差异更为明显，美国黑人人口中 PM _2.5 从 1990 年到 2016 年的所有年份。我们的模型估计，美国黑人和非西班牙裔白人之间年龄调整全因死亡率差异的一半以上可归因于 PM _2.5 2000 年至 2011 年。这种差异在 2000 年至 2015 年期间仅略有下降，分别从 53.4%（95% 置信区间 51.2-55.9%）下降到 49.9%（95% 置信区间 47.8-52.2%）。我们的研究结果强调需要采取有针对性的空气质量干预措施来解决环境健康差异。