ľ¹Ï¸£ÀûÓ°ÊÓ

Cardiovascular disease disparities across ethnicity and intersecting socioeconomic positions: The role of air pollution and green space. PhD thesis Lieke van den Brekel In the Netherlands, cardiovascular diseases such as heart attacks and strokes are unevenly distributed across the population. These diseases occur more frequently among people with a migration background and those with a lower socioeconomic status. This dissertation investigates the extent to which air pollution and access to green space, such as parks, contribute to these disparities in cardiovascular disease.

Air Pollution
Analyses based on data from Statistics Netherlands and national air pollution records show that residents with a migration background are exposed to higher levels of air pollution (soot, nitrogen dioxide, and particulate matter) at their home address than residents with a Dutch background. Among the largest migrant groups in the Netherlands, exposure to air pollution was particularly high for Surinamese, Moroccan, Turkish, and Dutch-Caribbean populations with a lower socioeconomic status living in urban areas.
For residents of Surinamese and Dutch-Caribbean descent, differences in exposure to air pollution accounted for between 7.9% and 14.7% of the increased risk of stroke. Moreover, the effect of air pollution on the risk of stroke and heart attack was not the same across all population groups. Reducing disparities in exposure to air pollution is therefore crucial to addressing health inequalities.
Green Space
Accessible and attractive green spaces are important for health and well-being. A sub-study in this dissertation shows that, for women of Turkish or South Asian-Surinamese background living in disadvantaged neighborhoods in Utrecht and The Hague, the use of green spaces is influenced by various factors. These include feelings of safety, the presence of facilities, and social aspects. Improving these environmental factors can enhance access to and use of green spaces.
Conclusion
Environmental factors that influence health are unequally distributed in the Netherlands, contributing to existing disparities in cardiovascular disease. Addressing inequality in these environmental factors is essential for reducing differences in cardiovascular health outcomes.