Health effects of air pollution
Racism, poverty and exposure to air pollution are interlinked. The ‘triple burden’ describes how people from racially minoritised and low income backgrounds have a higher risk of health issues due to air pollution.
Racially minoritised communities and people living in lower-income areas face disproportionate exposure and health issues from air pollution.
The triple burden of harm refers to more exposure to polluted air, greater risk of harm, and less power to advocate for clean air.
This is the first of two articles about race equity and air pollution.
Every year, air pollution contributes to up to 30,000 premature deaths in the UK while costing the economy £27bn. While air pollution harms us all, it doesn’t affect everyone equally. Children, older people, and those with existing health conditions are physically at greater risk from air pollution. Racially minoritised communities, as well as people living in lower-income areas, often face disproportionate exposure and harm.
We set out to better understand:
Our work reflects Impact on Urban Health’s commitment to race equity as health equity, and to better understanding what this means in practice. In this article, we share our framework and some of the insights that emerged from our learning journey. We’re sharing our findings because we believe other organisations – funders, campaigners, councils, and governments – can learn from our approach and adopt an equitable approach to improving air quality for everyone.
We began by developing a ‘triple burden’ framework, building on work by the Institute for Health Equity at UCL, Greater London Authority, and others: Health Inequalities in London (PDF).
The ‘triple burden’ gives us a quick way to describe some of the unequal conditions that can produce health inequalities related to air pollution:
We used the triple burden framework to organise the evidence we found. Across all three dimensions, we found evidence by both race and income:
Black and other racially minoritised people in the UK are more likely to experience poverty. However, research indicates that even at similar income levels, racial disparities in exposure (England) and health effects of air pollution (UK) remain, suggesting that race and income reveal different aspects of how unequal conditions are produced.
The triple burden framework gives us a way to describe why groups affected by racism or other systemic marginalisation experience disproportionate health effects of air pollution through three pathways: living in polluted areas or in homes affected by mould and damp combined with limited housing choices (personal exposure), barriers to healthcare and poorer underlying health (risk of harm), and less representation in public decision-making (as a proxy for power to advocate for clean air).
It also gives us a framework for designing a programme of equitable clean air interventions: targeting areas with highest exposure and greatest risk of harm and building community power to influence decision-making.
Broad, universal air quality policies, such as national and sectoral air quality standards, are key to the policy framework for cleaning the air, but they don’t automatically reduce inequalities, and sometimes they can even increase them. For example, in England, average PM2.5 exposure fell by 54% between 2003 and 2023, but lower-income areas still had persistently higher PM2.5 levels than richer areas.
Researchers and policymakers have speculated that an equity lens could make clean air policy more effective by identifying where and why different actions are needed, ensuring no one is left behind, and building public buy-in and community power over time.
A US study modelled three national strategies to reduce air pollution and found that targeting the most overburdened neighbourhoods was more effective at eliminating disparities and equally effective at reducing overall pollution, compared to traditional regional or sector-wide approaches.
Defra has noted that air pollution regulations can underperform (Air pollution horizon-scanning, PDF) when they don’t account for proximity to affected communities, and that lower-income households may retain polluting systems longer during the transition to net zero. Perceived failures in public health improvements could weaken public support for climate action.
This is the first of two articles we’ll be publishing about race equity and air pollution. In the next article, we’ll explain what we can learn from projects around the world about how to equitably improve air quality.
Health effects of air pollution
In February we joined a thought-provoking discussion in the Houses of Parliament, focused on the intersection of racial justice and air pollution. In this article, we set out our takeaways from the event, as well next steps.
Health effects of air pollution
Our Amplifying Voices strand supports the communities who are most affected by air pollution to advocate for change.
Health effects of air pollution
Our Freedom of Information request finds Children living in the most deprived areas recorded 56,842 hospital admissions for selected respiratory conditions in 2024/25. That disparity is exacerbated by air pollution.