Environmental Justice and Health Risk Exposure (10A) Practice Test

Residents of an industrial zone report frequent odors and dust from nearby factories. A school nurse tracks asthma outcomes in two middle schools: School I (within 0.5 miles of factories) and School II (3 miles away). Both schools follow the same district asthma action plan. Many families near School I have limited transportation and fewer options to move.

Summary data:

• Students with an asthma diagnosis: School I = 19%, School II = 11%
• Asthma-related absences (days/student/year among students with asthma): School I = 6.2, School II = 3.1
• Median household income in school catchment area: I = $42k, II = $78k

Based on the vignette, how does social inequality affect health outcomes?

An urban neighborhood located near two major highways and a freight depot reports frequent truck traffic and visible soot on windowsills. A local clinic compares residents of this neighborhood (Neighborhood A) with a higher-income neighborhood 4 miles away (Neighborhood B). Most residents in Neighborhood A are renters, and fewer households have central air conditioning. The clinic reports the following:

• Annual average fine particulate matter (PM$_{2.5}$): A = 14.2 $\mu$g/m$^3$, B = 8.1 $\mu$g/m$^3$
• Childhood asthma ED visits (per 1,000 children/year): A = 38, B = 14
• Households below the poverty line: A = 31%, B = 9%

Based on the vignette, how does social inequality most directly affect health outcomes in Neighborhood A?