2926

Background: Urban design features are often studied in relation to health and behavioral outcomes. They can also have major implications for environmental outcomes. Yet the impact of these features on both health and environmental outcomes (co-benefits) are rarely examined. We investigated how urban landscape and street design profiles are related to jointly occurring health and environmental outcomes in Latin America cities.
Methods: The SALURBAL project has compiled and harmonized data on built environment, environmental exposures, and health outcomes for 370 cities in 11 countries: Argentina, Brazil, Chile, Colombia, Costa Rica, El Salvador, Guatemala, Mexico, Nicaragua, Panama, and Peru. Eight city profiles were identified using finite mixture models. Four urban landscape profiles were defined measuring patch (contiguous area of urban development) fragmentation, shape, and isolation. Additional four street design profiles were defined using street connectivity, length, and directness. Multilevel regression models were used to assess associations between the city profiles and several health and environmental outcomes.
Results (preliminar): As compared to the urban landscape profile labelled ‘scattered pixels’ (low fragmentation, compact shape, high isolation), the ‘proximate stones’ profile (moderate fragmentation, irregular shape, moderate isolation) had significantly higher levels of PM_2.5 and NO₂, and the ‘proximate inkblots’ profile (moderate-high fragmentation, complex shape, moderate isolation) had significantly higher violence related deaths. As compared to the street design profile labelled ‘labyrinthine’ (low connectivity, moderate length, moderate directness), the ‘semi-hyperbolic grid’ (moderate connectivity, moderate length, moderate directness) and the ‘spiderweb’ (high connectivity, low length, moderate directness) profiles had significantly higher levels of PM_2.5 and NO₂. While the ‘hyperbolic grid’ profile (moderate connectivity, high length, low directness) had significantly higher levels of NO₂ and lower levels of obesity.
Conclusion: Identifying how city profiles are related to environment and health outcomes can shed light on the urban policies that could have the greatest environment and health co-benefits.

3254

Background: The incidence of SARS-CoV-2 is growing in Latin American cities, where air pollution exposures and chronic diseases are often distributed inequitably. Long-term exposure to ambient air pollution has been linked to more severe COVID-19 outcomes. Objectives: For four major Latin American cities, we compared ambient fine particulate matter (PM_2.5) concentrations during COVID-19-related lockdowns with previous years. We estimated the impact on adult mortality if current ambient PM_2.5 reductions were maintained long-term. Methods: We compared PM_2.5 concentrations during the first week of COVID-19-related school closures in 2020 with the same period during 2017 - 2019 in Lima, São Paulo, Santiago, and Mexico City. For each city, we estimated the impact on adult mortality if long-term PM_2.5 concentrations were lower proportional to the COVID-19-related reductions observed in 2020. Discussion: In all four cities, weekly ambient PM_2.5 was lower during the first week of COVID-19 school closures compared to previous years, ranging from -41% in Lima to -5% in Mexico City. In a counterfactual scenario where long-term, annual ambient PM_2.5 was reduced proportionally to these levels, all-cause mortality among adults aged ≥ 30 years would be substantially reduced: 7% lower in Lima (95% confidence interval [CI] 4% to 9%); 3% lower in São Paulo (95% CI 2% to 4%) and Santiago (95% CI 2% to 4%); and 0.6% lower in Mexico City (95% CI 0.4% to 0.8%). Ambient air pollution is responsible for 145,000 deaths annually in the region, and these deaths are often distributed inequitably. Previous efforts to reduce ambient air pollution have faced resistance due to perceived economic cost. As national and municipal governments look to relax COVID-19 restrictions while prioritizing public health, there is a critical window of opportunity to implement policies which reduce ambient air pollution, prevent chronic disease, and promote health equity in the region.

1856

BACKGROUND: Several studies have examined whether air pollution is associated to adverse births outcomes but it is not clear if socioeconomic status (SES) modifies this relationship. OBJECTIVES: We investigated if individual and area-level socioeconomic status modified the relationship between ozone, nitrogen dioxide and particulate matter with aerodynamic diameter <10µm (PM₁₀) and preterm deliveries (gestational age <37 weeks) and term low birth weight (TLBW; < 2500g). METHODS: Analyses were based on almost 1 million singleton live births in São Paulo municipality between 2011 and 2016. Exposure to PM₁₀, NO₂ and O₃ were estimated by average trimestral and entire gestation based on date of birth and using daily averages of air pollution from the network of monitoring stations. Multilevel logistic regression models were conducted to examine the effect of air pollutants on both birth outcomes and whether it was modified by SES. RESULTS: In fully adjusted models, over the entire pregnancy, a 10µg/m³ increase in O₃ and PM₁₀ was associated to PTD (odds ratio; OR = 1.14 CI 1.13,1.16 and 1.08 CI = 1.02,1.15 respectively) and PM₁₀ was associated to TLBW (OR = 1.08 CI 1.03, 1.14). Associations were modified by individual and area-level SES for both outcomes (p<0,001). Mothers with low individual SES had an additional risk for PTD and TLBW associated with PM₁₀ exposure (OR = 1.04 CI 1.04,1.05 and 1.10 CI 1.08,1.14 respectively). Lower area-level SES also implied in a stronger risk for TLBW (OR = 1.05 CI 1.03,1.06). Similar effect modifications were observed for O₃ exposure. Trimester specific associations were weaker but followed a similar pattern. CONCLUSION: Individual and neighborhood socioeconomic status modifies the effect of air pollution on adverse birth outcomes. Mothers with lower SES may be more susceptible to adverse pregnancy outcomes associated with air pollution exposure.