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Environmental and social inequities in continental France: an analysis of exposure to heat, air pollution, and lack of vegetation

Journal of Exposure Science & Environmental Epidemiology (2024)Cite this article

Abstract

Background

Cumulative environmental exposures and social deprivation increase health vulnerability and limit the capacity of populations to adapt to climate change.

Objective

Our study aimed at providing a fine-scale characterization of exposure to heat, air pollution, and lack of vegetation in continental France between 2000 and 2018, describing spatiotemporal trends and environmental hotspots (i.e., areas that cumulate the highest levels of overexposure), and exploring any associations with social deprivation.

Methods

The European (EDI) and French (FDep) social deprivation indices, the normalized difference vegetation index, daily ambient temperatures, particulate matter (PM2.5 and PM10), nitrogen dioxide, and ozone (O3) concentrations were estimated for 48,185 French census districts. Reference values were chosen to characterize (over-)exposure. Hotspots were defined as the areas cumulating the highest overexposure to temperature, air pollution, and lack of vegetation. Associations between heat overexposure or hotspots and social deprivation were assessed using logistic regressions.

Results

Overexposure to heat was higher in 2015–2018 compared with 2000–2014. Exposure to all air pollutants except for O3 decreased during the study period. In 2018, more than 79% of the urban census districts exceeded the 2021 WHO air quality guidelines. The evolution of vegetation density between 2000 and 2018 was heterogeneous across continental France. In urban areas, the most deprived census districts were at a higher risk of being hotspots (odds ratio (OR): 10.86, 95% CI: 9.87–11.98 using EDI and OR: 1.07, 95% CI: 1.04–1.11 using FDep).

Impact statement

We studied cumulative environmental exposures and social deprivation in French census districts. The 2015–2018 period showed the highest overexposure to heat between 2000 and 2018. In 2018, the air quality did not meet the 2021 WHO guidelines in most census districts and 8.6 million people lived in environmental hotspots. Highly socially deprived urban areas had a higher risk of being in a hotspot. This study proposes for the first time, a methodology to identify hotspots of exposure to heat, air pollution, and lack of vegetation and their associations with social deprivation at a national level.

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Fig. 1: Temporal evolution of the exposures between 2000 and 2018 in urban and rural IRIS in continental France.
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Data availability

The datasets generated during and analyzed during the current study are being made available on htts://www.data.gouv.fr. They are also available from the corresponding author on reasonable request.

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Acknowledgements

This work is part of a PhD thesis associated with the Doctoral Network in Public Health coordinated by the Public Health School EHESP. The authors would like to thank INERIS (French Institute for Industrial Environment and Risks) for commenting on the manuscript and making available in open data the air pollutant concentration data from which the NO2 and O3 concentrations used in this study were taken: https://www.ineris.fr/fr/recherche-appui/risques-chroniques/mesure-prevision-qualite-air/qualite-air-france-metropolitaine. The authors also acknowledge the French League against Cancer (Ligue nationale contre le cancer). The graphical abstract was designed using images from Flaticon.com.

Funding

This work is part of a PhD thesis funded by Santé publique France (French Public Health Agency).

Author information

Author notes

  1. These authors contributed equally: Mathilde Pascal, Johanna Lepeule.

Authors and Affiliations

  1. Santé publique France, 12 rue du Val d’Osne, 94415, Saint-Maurice Cedex, France

    Lucie Adélaïde & Mathilde Pascal

  2. Université Grenoble Alpes, Inserm, CNRS, IAB, Site Santé, Allée des Alpes, 38700, La Tronche, France

    Lucie Adélaïde, Ian Hough, Emie Seyve & Johanna Lepeule

  3. Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Be’er Sheva, Israel

    Ian Hough & Itai Kloog

  4. Université de Paris Cité, Inserm, INRAE, Centre of Research in Epidemiology and StatisticS (CRESS), 75000, Paris, France

    Emie Seyve

  5. Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Itai Kloog

  6. Météo-France, 73 avenue de Paris, 94165, Saint-Mandé Cedex, France

    Grégory Fifre

  7. U1086 Inserm Anticipe, Avenue Général Harris, 14076, Caen Cedex, France

    Guy Launoy & Ludivine Launay

  8. University Hospital of Caen, 14076, Caen Cedex, France

    Guy Launoy

  9. Plateforme MapInMed, US PLATON, Avenue Général Harris, 14076, Caen Cedex, France

    Ludivine Launay

  10. Centre François Baclesse, Avenue Général Harris, 14076, Caen Cedex, France

    Ludivine Launay

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Contributions

LA, MP and JL designed and conceived this study with support from GF. LA conducted the analysis and prepared the original draft of the manuscript with support from MP and JL. IH and ES contributed to data curation. IH, ES, JL and IK acquired the data. LA, IH, ES, GF, GL, LL, MP and JL interpreted the results. IH, ES, GF, IK, GL, LL, MP and JL reviewed the manuscript and provided substantial feedback. All authors read and approved the final manuscript.

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Correspondence to Lucie Adélaïde or Johanna Lepeule.

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Adélaïde, L., Hough, I., Seyve, E. et al. Environmental and social inequities in continental France: an analysis of exposure to heat, air pollution, and lack of vegetation. J Expo Sci Environ Epidemiol (2024). https://doi.org/10.1038/s41370-024-00641-6

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