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Most of the studies on air pollution have included populations whose socioeconomic status is higher than the national average and who reside in well-monitored urban areas. This does not tell us what the health effects are of long-term exposure to low levels of air pollution in smaller cities and rural areas or among minorities or persons with low socioeconomic status (sensitive populations). This study involved 60 million people in the United States who receive Medicare and live in smaller cities or rural areas. This study showed that long-term exposures to particulate matter less than 2.5 μm and ozone were associated with a 7.3% increased risk of death, even at levels below the current annual national safety standards. In another study, the authors also looked at Medicare recipients and air pollution exposure risks and found that lifestyle factors such as smoking, BMI, and many other potential confounders did not change the data. With air pollution declining, it is critical to estimate the health effects of low levels of air pollution, below the current National standards, in order to determine whether these levels are adequate to minimize the risk of death. The Clean Air Act requires the EPA to set air quality standards that protect sensitive populations (such as those on Medicare) and studies like this may be important in order to inform regulatory policy going forward.

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