Air Pollution and Cardiovascular Risk

“In terms of numbers of deaths, air pollution’s greatest impact is through cardiovascular mortality.” This was shocking to me as I had always considered that pulmonary consequences of pollution (COPD, asthma, lung cancer) were the most significant causes of mortality related to pollution. However, the authors go on to state that the six cities study attributed 6x as many deaths due to cardiovascular disease compared to respiratory disease. The authors acknowledge that this data may be surprising to many people, but because cardiovascular disease is our country’s leading cause of death, any factor that continues to this will certainly be significant. I think that most people, even doctors, would be surprised to know that pollution is a contributor to cardiovascular disease and its mortality. I think that if more people knew this, they would perhaps have more urgency in thinking about pollution and its effects on not only the environment, but our health.

This section also made me consider how much of the onus for cardiovascular disease we place on the individual. When someone has a heart attack, for instance, most people blame the individual; he/she ate too much fast food, or they didn’t exercise, or they smoked, etc. Even in the medical realm, we tend to place greater weight on the personal factors rather than community factors like does the person have access to fresh foods, does their job give them time to exercise, or perhaps is their smoking a way of self-medicating stress or schizophrenia. As a result of learning that the majority of deaths attributable to pollution come from cardiovascular causes, it makes me wonder how we should reframe our thinking to consider this when treating patients and preventing disease. I’m not suggesting that we worry more about pollution than an individual’s own choices relating to their health, but that it should be another factor to consider. Perhaps shifting some of this blame will cause us to refocus some of our concern towards pollution and the environment. I wonder, can this knowledge be a motivator for getting people to care about pollution and the environment?