Publication

Concentrated animal feeding operations (CAFOs) have emerged as an environmental justice issue due to dispro-portionate siting in low-income and minority communities. However, CAFOs' impact on health is not fully under-stood. We examined risk of cause-specific mortality associated with CAFOs in North Carolina (NC) for 2000-2017 and health disparities. We obtained data on individual-level cause-specific mortality and on permitted animal fa-cilities. We estimated associations between exposure to CAFOs and cause-specific mortality using logistic regres-sion, controlling for demographics (e.g., age) and area-level covariates. To estimate exposure to CAFOs, we considered (1) a binary indicator (presence or absence) of CAFOs within a buffer around individual residence based on several buffer sizes, and (2) four levels of exposure (no, low, medium, and high) based on the number of CAFOs within 15 km around each residence. We considered individual-level (sex, race/ethnicity, age, educa-tion) and community-level (median household income, urbanicity, and region) factors. Under all buffer sizes used to estimate CAFOs exposure, people living near CAFOs had significantly higher risk of cardiovascular mor-tality than other persons. Comparing those living near CAFOs to the no exposure group, odds ratios (ORs) for car-diovascular mortality were 1.01 (95% confidence interval (CI) 1.00, 1.03), 1.04 (1.03, 1.06), and 1.06 (1.05, 1.07) for low, medium, and high CAFOs exposure, respectively, indicating a trend of higher risk with higher exposure. Those in the high CAFOs exposure group had significantly higher risk of anemia and kidney disease mortality than those with no exposure. Results suggest higher mortality risk from CAFOs for some subpopulations, how-ever differences were not statistically significant. Findings provide evidence of excess mortality risk from CAFOs in NC. These results have implications for future studies of environmental justice and CAFOs. (c) 2021 Elsevier B.V. All rights reserved.