ORIGINAL RESEARCH article
Front. Public Health
Sec. Environmental Health and Exposome
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1607163
Global Burden of Ischemic Heart Disease Attributable to Ambient and Household PM2.5 Exposure: A Comprehensive Analysis (1990-2021) from Socioeconomics perspective
Provisionally accepted
- 1School of Public Health, Xi’an Jiaotong University, Xi'an, China
- 2School of Energy and Power Engineering, Xi'an Jiaotong University, Xi’an, China
- 3Xi'an Jiaotong University, Xi'an, China
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Objectives: Socioeconomic status links to exposure of air pollutants. This study evaluates global PM2.5-attributable ischemic heart disease (IHD) burden from 1990-Methods: Using Global Burden of Disease (GBD) 2021 data, PM2.5-related IHD burdens were analyzed. Joinpoint regression identified annual percentage changes (AAPCs); Pearson correlation assessed associations with Socio-demographic Index (SDI); Slope Index of Inequality (SII) and Concentration Index (CI) were applied to quantify inequality; Frontier analysis was conducted to evaluate the efficiency of health outcomes relative to development level; Decomposition analysis was performed to identify key drivers of burden changes over time.Results: From 1990 to 2021, age-standardized rates (ASMR, ASDR) of IHD attributable to ambient PM2.5 declined to 20.85 per 100,000 (AAPC= -0.7), with attributable to household PM2.5 decreased to 9.02 per 100,000 (AAPC= -2.49). Middlelow SDI regions exhibited the highest increases in ambient PM2.5-related burden, whereas high SDI regions showed marked declines (AAPC= -4.31). All regions showed downward in household PM2.5-attributable ASMR and ASDR. Disease burden was disproportionately higher among males and older populations. ASMR and ASDR of IHD exhibited a nonlinear association with SDI. PM2.5 demonstrated positive correlation in regions with SDI<0.49, and negative correlation in regions with SDI > 0.623. SII and CI indicated rising inequality in ambient PM2.5-related burden. Frontier analysis revealed efficiency gaps in low-SDI regions. Decomposition highlighted population aging and ambient PM2.5 exposure as major drivers of burden trends.Ambient pollution burdens increase in middle-SDI and household pollution impacts focus on low-SDI, which needs prioritizing clean energy and protecting high-risk populations.
Keywords: Ischemic Heart Disease, Global burden of disease, PM2.5, Ambient pollution, Household air pollution, socio-demographic index
Received: 07 Apr 2025; Accepted: 30 Jun 2025.
Copyright: © 2025 Zhang, Su, Xi, Li, Xu, Cheng and Han. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Bei Han, Xi'an Jiaotong University, Xi'an, China
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