Long-term PM2.5 exposure and mental health disparities: A prospective analysis of the All of Us Research Program.

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Title: Long-term PM2.5 exposure and mental health disparities: A prospective analysis of the All of Us Research Program.
Authors: Burrows, Kate1 (AUTHOR) kburrows@uchicago.edu, Luo, Jiajun2,3 (AUTHOR), Cai, Yuxuan4 (AUTHOR), Aschebrook-Kilfoy, Briseis3,5 (AUTHOR)
Source: Environmental Research. Nov2025:Part 5, Vol. 285, pN.PAG-N.PAG. 1p.
Subjects: Mental health, Anxiety, Ethnicity, Mental depression, Socioeconomic status, Cohort analysis, Racial inequality, Particulate matter
Geographic Terms: United States
Abstract: Despite known environmental inequities, the impact of air pollution on mental health across diverse populations remains uncharacterized, with prior research limited largely to cross-sectional studies or homogeneous cohorts. In this paper we evaluated associations between long-term fine particulate matter (PM 2.5) exposure and incident depression and anxiety in a large, diverse cohort and investigated effect modification by race/ethnicity, insurance status, and neighborhood-level socioeconomic status. We used data from the All of Us Research Program (2018–2022) to analyze two cohorts (n > 100,000 each) to identify incident cases of depression and anxiety. We assigned annual average PM 2.5 concentrations based on residential zip-codes and used Cox proportional hazards models with natural cubic splines to estimate associations, adjusting for individual and community-level covariates. For a 10-μg/m3 increase in PM 2.5 , the hazard ratio (HR) was 2.14 (95 % CI: 1.41, 3.24) for anxiety and 1.66 (95 % CI: 1.02, 2.70) for depression. Comparing highest to lowest PM 2.5 quartile, the HR was 1.10 (95 % CI: 1.03–1.19) for anxiety and 1.45 (95 % CI: 1.33–1.57) for depression. Depression risks were elevated even at PM 2.5 levels below the EPA standard of 9.0 μg/m3, while anxiety risks increased only at higher concentrations. Black participants showed approximately twice the risk of both outcomes compared to other racial groups, which may reflect the cumulative impacts of systemic racism in the United States, including residential segregation, limited healthcare access, and chronic stress. Results emphasize the need for targeted interventions in communities facing multiple structural disadvantages. [ABSTRACT FROM AUTHOR]
Copyright of Environmental Research is the property of Academic Press Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Long-term PM2.5 exposure and mental health disparities: A prospective analysis of the All of Us Research Program.
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  Data: <searchLink fieldCode="DE" term="%22Mental+health%22">Mental health</searchLink><br /><searchLink fieldCode="DE" term="%22Anxiety%22">Anxiety</searchLink><br /><searchLink fieldCode="DE" term="%22Ethnicity%22">Ethnicity</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Socioeconomic+status%22">Socioeconomic status</searchLink><br /><searchLink fieldCode="DE" term="%22Cohort+analysis%22">Cohort analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Racial+inequality%22">Racial inequality</searchLink><br /><searchLink fieldCode="DE" term="%22Particulate+matter%22">Particulate matter</searchLink>
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  Data: Despite known environmental inequities, the impact of air pollution on mental health across diverse populations remains uncharacterized, with prior research limited largely to cross-sectional studies or homogeneous cohorts. In this paper we evaluated associations between long-term fine particulate matter (PM 2.5) exposure and incident depression and anxiety in a large, diverse cohort and investigated effect modification by race/ethnicity, insurance status, and neighborhood-level socioeconomic status. We used data from the All of Us Research Program (2018–2022) to analyze two cohorts (n > 100,000 each) to identify incident cases of depression and anxiety. We assigned annual average PM 2.5 concentrations based on residential zip-codes and used Cox proportional hazards models with natural cubic splines to estimate associations, adjusting for individual and community-level covariates. For a 10-μg/m3 increase in PM 2.5 , the hazard ratio (HR) was 2.14 (95 % CI: 1.41, 3.24) for anxiety and 1.66 (95 % CI: 1.02, 2.70) for depression. Comparing highest to lowest PM 2.5 quartile, the HR was 1.10 (95 % CI: 1.03–1.19) for anxiety and 1.45 (95 % CI: 1.33–1.57) for depression. Depression risks were elevated even at PM 2.5 levels below the EPA standard of 9.0 μg/m3, while anxiety risks increased only at higher concentrations. Black participants showed approximately twice the risk of both outcomes compared to other racial groups, which may reflect the cumulative impacts of systemic racism in the United States, including residential segregation, limited healthcare access, and chronic stress. Results emphasize the need for targeted interventions in communities facing multiple structural disadvantages. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Group: Ab
  Data: <i>Copyright of Environmental Research is the property of Academic Press Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1016/j.envres.2025.122691
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      – Code: eng
        Text: English
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        PageCount: 1
        StartPage: N.PAG
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      – SubjectFull: Mental health
        Type: general
      – SubjectFull: Anxiety
        Type: general
      – SubjectFull: Ethnicity
        Type: general
      – SubjectFull: Mental depression
        Type: general
      – SubjectFull: Socioeconomic status
        Type: general
      – SubjectFull: Cohort analysis
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      – SubjectFull: Racial inequality
        Type: general
      – SubjectFull: Particulate matter
        Type: general
      – SubjectFull: United States
        Type: general
    Titles:
      – TitleFull: Long-term PM2.5 exposure and mental health disparities: A prospective analysis of the All of Us Research Program.
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              Text: Nov2025:Part 5
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              Y: 2025
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