Inequalities in cumulative environmental burdens among three urbanized counties in California.

Low-income communities and communities of color often suffer from multiple environmental hazards that pose risks to their health. Here we extended a cumulative environmental hazard inequality index (CEHII) - developed to assess inequalities in air pollution hazards - to compare the inequality among three urban counties in California: Alameda, San Diego, and Los Angeles. We included a metric for heat stress to the analysis because exposure to excessively hot weather is increasingly recognized as a threat to human health and well-being. We determined if inequalities from heat stress differed between the three regions and if this added factor modified the metric for inequality from cumulative exposure to air pollution. This analysis indicated that of the three air pollutants considered, diesel particulate matter had the greatest inequality, followed by nitrogen dioxide (NO(2)) and fine particulate matter (PM(2.5)). As measured by our index, the inequalities from cumulative exposure to air pollution were greater than those of single pollutants. Inequalities were significantly different among single air pollutant hazards within each region and between regions; however, inequalities from the cumulative burdens did not differ significantly between any two regions. Modeled absolute and relative heat stress inequalities were small except for relative heat stress in San Diego which had the second highest inequality. Our analysis, techniques, and results provide useful insights for policy makers to assess inequalities between regions and address factors that contribute to overall environmental inequality within each region.