Assessment of environmental injustice in Korea using synthetic air quality index and multiple indicators of socioeconomic status: A cross-sectional study.

UNLABELLED: Despite the existence of the universal right to a healthy environment, the right is being violated in some populations. The objective of the current study is to verify environmental discrimination associated with socioeconomic status in Korea, using synthetic air quality index and multiple indicators of socioeconomic status. The concentrations of NO₂(nitrogen dioxide), CO (carbon monoxide), SO₂(sulfur dioxide), PM10 (particulate matter with an aerodynamic diameter <10 μm), and O₃(ozone) in ambient air were integrated into a synthetic air quality index. Socioeconomic status was measured at individual level (income, education, number of household members, occupation, and National Basic Livelihood status) and area level (neighborhood index). The neighborhood index was calculated in the finest administrative unit (municipality) by performing standardization and integration of municipality-level data of the following: number of families receiving National Basic Livelihood, proportion of people engaged in an elementary occupation, population density, and number of service industries. Each study participant was assigned a neighborhood index value of the municipality in which they reside. Six regression models were generated to analyze the relationship between socioeconomic status and overall air pollution. All models were adjusted with sex, age, and smoking status. Stratification was conducted by residency (urban/rural). Moran's I was calculated to identify spatial clusters, and adjusted regression analysis was conducted to account for spatial autocorrelation. Results showed that people with higher neighborhood index, people living with smaller number of family members, and people with no education lived in municipalities with better overall air quality. The association differed by residency in some cases, and consideration of spatial autocorrelation altered the association. This study gives strength to the idea that environmental discrimination exists in some socioeconomic groups in Korea, and that residency and spatial autocorrelation must be considered in order to fully understand environmental disparities. IMPLICATIONS: This is the first study that provides the possible evidence of the environmental injustice in Korea using air quality index. The findings suggested that air quality index was negatively correlated with several important socioeconomic status measured at either individual or area level. The main implication of this paper, therefore, is to provide another insight to environmental policy makers to consider environmental injustice problem into community intervention for resolving the public health problems by air pollution.