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UCLA-led Study Finds SARS Death Rate Doubles in Cities With Poor Air QualityDate: November 19, 2003Contact: Sarah Anderson (email)Phone: (310) 794-2265 A new study led by researchers at the UCLA School of Public Health associates air pollution with an increased risk of dying from Severe Acute Respiratory Syndrome, or SARS. Published this week in the peer-reviewed journal Environmental Health: A Global Access Science Source, the study shows that patients with SARS are more than twice as likely to die from the disease if they come from areas of high pollution. "Long-term and short-term exposure to air pollution has been associated with a variety of adverse health effects including acute respiratory inflammation, asthma and chronic obstructive pulmonary disease — and now SARS," said Dr. Zuo-Feng Zhang, a professor of epidemiology at the UCLA School of Public Health and a leading scientist of the study. "Our findings suggest that caregivers need to pay close attention to exposure to pollutants in the living and working environments of SARS patients. These factors and others related to exposure to airborne toxins could leave some individuals at grea ter risk of death from the illness than others." Since November of 2002, 5,327 cases of SARS have been diagnosed in mainland China, and so far 349 patients have died from the disease. SARS death rates vary between regions of the country, with higher rates in the north of China. A team of researchers from the UCLA School of Public Health, the Jiangsu Provincial Center for Disease Control and Prevention, and Fudan University School of Public Health investigated whether these differences could be explained by differences in air pollution levels. Using publicly available SARS data, the researchers assessed the death rates of patients with SARS in five different regions of China. They used data published by the Chinese National Environmental Protection Agency to assess the air pollution levels in these different regions between April and May 2003, when the majority of SARS cases were diagnosed. The researchers categorized the regions according to their level of air pollution. Guangdong, with an air pollution index of 75, was said to have a low level of pollution; Tianjin, with an air pollution index of more than 100, a high level of pollution; and Shanxi, Hebei and Beijing, moderate pollution levels. Mortality rates of patients with SARS increased as pollutio n levels increased. In regions with low air pollution, the death rate was 4.08 percent, whereas in areas with moderate or high air pollution levels, the death rates were 7.49 percent and 8.9 percent, respectively. The researchers were unable to examine the socioeconomic status or the smoking habits of the SARS patients, nor did they consider the treatment that the patients were given. All of these may have contributed to the patients’ outcome. However, the two regions with the highest case fatality rates were Beijing and Tianjin. The researchers suspect that patients would probably have received better clinical support in these areas. If this is the case, then air pollution may play an even greater role in increasing death rates than their data suggests. Other researchers involved in the study included Yan Cui and Roger Detels of the epidemiology department at the UCLA School of Public Health; John Froines of the Southern California Particle Center and Supersite, and UCLA School of Public Health; Jinkou Zhao and Hua Wang of the Jiangsu Provincial Center for Disease Control and Prevention in Nanjing, China; and Shun-Zhang Yu of the School of Public Health at Fudan University in Shanghai, China. The UCLA School of Public Health is dedicated to enhancing the public’s health by conducting innovative research, training future leaders and health professionals, translating research into policy and practice, and serving local, national and international communities. Detailed information about the school is available online at www.ph.ucla.edu. Use of potentially life-saving cancer screening procedures among California adults varies dramatically depending on race and ethnicity, according to a new study by the UCLA Center for Health Policy Research. The differences - attributed to cultural, education, language and other barriers - persist even when comparing like income levels or health insurance status across racial and ethnic groups. Lower screening rates reduce the odds of early detection for hundreds of thousands of Californians and survival rates for those who contract cancer. The report was based on data from the 2001 California Health Interview Survey (CHIS 2001) and funded by The California Endowment. Researchers examined screening rates for cervical, breast, colorectal and prostate cancer among whites, Latinos, Asians, blacks, American Indian/Alaska Natives, and Native Hawaiian and other Pacific Islanders. "Our findings underscore the reality that racial and ethnic disparities in cancer screening and other important health services can be found even within similar socioeconomic groups, such as low-income families and Medi-Cal beneficiaries," said author Ninez A. Ponce, a center researcher and assistant professor of health services at the UCLA School of Public Health, and a member of the Jonsson Comprehensive Cancer Center at UCLA. "Clearly, targeting investment wisely toward the specific racial and ethnic groups most at risk remains a necessary step to save lives in California and reduce the burden of late-stage cancer care on the state's health care system," said author Susan H. Babey, a researcher at the UCLA Center for Health Policy Research. "Improving the health of California's diverse communities is dependent on this critical information that helps identify the gaps that exist in health care and provides health leaders and community organizations with the information to improve access to preventive care for ethnic and racial minorities," said Alicia Lara, vice president of program for the endowment. Screening saves lives by detecting cancer or pre-malignancies at a time when treatment typically is most successful. Five-year relative survival rates for breast, prostate, colorectal and cervical cancer rise above 90 percent if the tumor is discovered before it spreads to other parts of the body. Once a tumor is metastasized, survival rates drop to 34 percent for prostate cancer, 23 percent for breast cancer, 15 percent for cervical cancer and 9 percent for colorectal cancer. The report includes detailed screening rates for the four cancers by 1) race/ethnicity alone, 2) income and race/ethnicity, and 3) Medi-Cal coverage and race/ethnicity. Among key findings in the report:
Other report authors are E. Richard Brown, director of the UCLA Center for Health Policy Research and professor of public health; Neetu Chawla, a center researcher; David A. Etzioni of the David Geffen School of Medicine at UCLA; and Benjamin A. Spencer of the Greater Los Angeles VA Healthcare System. CHIS 2001 data were compiled from interviews of more than 55,000 randomly selected adults drawn from every county in California. A collaboration of the UCLA Center for Health Policy Research, the California Department of Health Services and the Public Health Institute, this biennial survey is the largest of its kind conducted in any state and one of the largest in the nation. In addition to releasing the report on cancer screening in California, the Center for Health Policy Research announced Sept. 18 the launch of CHIS 2003, funded in part by a $3.9 million grant from The California Endowment and through major support from the California Department of Health Services, the National Cancer Institute and the Robert Wood Johnson Foundation. The UCLA Center for Health Policy Research, established in 1994, is one of the nation's leading health policy research centers and the premier source of key health-policy information for California. It is based in the UCLA School of Public Health and is also affiliated with the UCLA School of Public Policy and Social Research. The Woodland Hills, Calif.-based California Endowment is a nonprofit organization dedicated to expanding access to affordable, quality health care for underserved individuals and communities, and to promote fundamental improvements in the health status of all Californians. Online resources:
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