A weekly roundup of public health news
Breast cancer linked to air pollution
Outdoor air pollution can increase breast cancer risks, the largest U.S. study of its kind confirms.
Published in the American Journal of Public Health, the research examined data on nearly 28,000 women, finding people exposed to nitrogen dioxide emissions were more likely to develop breast cancer. Each 10 parts per billion increase in exposure to NO2 — a pollutant mainly produced by vehicles — raised risks by 3%.
While other pollutants such as fine-particle matter, also known as PM2.5, and ozone did not increase breast cancer incidence, they did influence the type of tumors people with the disease had. Women with exposure to those two types of pollutants were more likely to have tumors that lacked estrogen and progesterone receptors, also known as ER-/PR-.
Even a small increase in PM2.5 exposure increased risks, the study found. Five micrograms more PM2.5 per cubic meter — equivalent to a pinch of dust in a refrigerator-sized space of air — was linked to a 14% higher risk of developing ER–/PR– breast cancer.
ER-/PR- tumors tend to be more aggressive and have fewer treatment options, as they do not respond to hormone therapies, which are the most commonly used treatments. About 11% of the more than 300,000 breast cancer cases diagnosed annually are ER-/PR-.
Other common sources of the air pollutants include power plants, industrial facilities and wildfire smoke.
U.S. death rate for kids under 5 on par with Albania
The U.S continues to lag behind most other high-income nations when it comes to maternal and child deaths, a new issue brief from The Commonwealth Fund says.
In 2023, the U.S. rate of infant mortality deaths, at 5.6 deaths per 1,000 live births, ranked between Qatar and Romania, according to the brief, which compared the U.S. to 200 countries. Nations with some of the lowest rates of infant deaths include Finland, Estonia and Japan.
While deaths among children under 5 held steady in the U.S., the nation’s rate of 6.7 deaths per 1,000 live births put it on par with Albania, a former Communist developing nation. America’s poor showing was driven in part by stark racial disparities: Black children under 5 died at a rate of 13.4 per 1,000 live births in 2023, nearly double the national average.
Black mothers continue to face the highest risk of maternal death in the U.S., with 50.3 deaths per 100,000 live births — a level similar to rates in Vietnam and Brazil. American Indian and Alaska Native mothers and Native Hawaiian and Pacific Islander mothers followed close behind, with 40.7 and 37 deaths per 1,000 births, respectively, for each group.
Despite a decrease in 2023, the overall U.S. maternal mortality rate, at 18.6 deaths per 100,000 live births, was higher than the majority of all other high-income countries.
At the state level, Mississippi — which recently declared infant mortality a public health emergency — had the highest rates of deaths among both infants and children under 5. Louisiana had the highest state rate of maternal deaths in 2023, at 41.9 per 1,000 live births.
Among the reasons for the disparities were differences in state-level policies, access to prenatal care and health insurance coverage.
Disadvantaged communities being hit hardest by hospital closures
Hospital closures across the U.S. are disproportionately hurting people who are already at risk for poorer health, new research finds.
Nearly 300 U.S. surgical hospitals closed from 2010 to 2020, according to the research, which was presented at the American College of Surgeons Clinical Congress. Compared to hospitals that stayed open, shuttered hospitals were more than twice as likely to be located in areas with high levels of social vulnerability, such as high poverty, low education, poor housing quality and a lack of transportation.
The number of U.S. geographic areas within a 15-minute drive of a surgical hospital fell by about 6% during the study period, while the number of areas within a 30-minute drive fell by almost 4%, researchers reported.
Hospital closures — which are being fueled by high operational costs, funding strains, staffing shortages and other causes — can put stress surrounding health care systems. Patients may also lose access to their medical history or forgo care.
Other recent public health news of note:
• Changes that are in store for Medicaid could lead to millions of sick people being kicked out of the program, a new study in the Journal of the American Medical Association says. About 5 million people — many of whom have chronic diseases or disabilities — may be disenrolled when new Medicaid work requirements take effect, researchers estimated.
• Personal inhalers used for asthma, chronic obstructive pulmonary disorder and other conditions contribute to greenhouse gas emissions, according to new research in JAMA. Carbon emissions from inhalers are equivalent to 530,000 cars annually, the study said.
• Heart disease deaths disproportionately occur among people in low-income communities, a new study in California finds. The research, presented at the American College of Cardiology’s Quality Summit, found significantly higher deaths in areas with lower average incomes as compared to higher ones. In Kern County, for example, where residents had an average income of about $67,000, the heart disease death rate was 89 per 100,000 people. In comparison, Marin County, with an average income of about $143,000, experienced 44 deaths per 100,000.
• Heavy nurse workloads can be harmful for infant care, new findings in JAMA Pediatrics show. Researchers found neonatal intensive care nurses were more likely to miss care when overseeing three or more infants on a shift.
• Exposure to wildfire smoke can be harmful for sperm quality, a new study in Fertility and Sterility says. Researchers found declines in sperm concentration, count and motility when men were exposed to wildfire smoke.
The Watch is written by Michele Late, who has more than two decades of experience as a public health journalist.