Despite growing evidence of health risks posed by animal feeding operations (AFOs) including concentrated AFOs (CAFOs), few studies have explored the associated disproportionate health burdens. We investigated risk of cause-specific mortality associated with AFO/CAFOs and related disparities for North Carolina, Pennsylvania, and Virginia (2000–2020). We estimated associations between AFO/CAFO exposure and mortality (anemia, asthma, COPD, diabetes mellitus, cerebrovascular disease, and kidney disease) using logistic regression. For each participant, we applied two exposure metrics based on buffers around population-weighted ZIP-code centroids: (1) binary exposure based on presence or absence of AFOs/CAFOs, and (2) exposure intensity (no exposure, low, medium, and high). We investigated health disparities by individual-level (sex, race/ethnicity, age, education, marital status) and community-level (race, income, poverty, education, racial isolation, educational isolation) characteristics. Presence of AFO/CAFOs was associated with higher risks of cause-specific mortality, particularly for diabetes mellitus or cerebrovascular disease, across all states. People in ZIP codes within ⩽10 km of AFO/CAFO were 1.028 (95% Confidence Interval 1.014, 1.042), 1.039 (1.025, 1.053), and 1.053 (1.031, 1.075) times more likely to die from cerebrovascular disease compared to those in ZIP codes without AFO/CAFO exposure for North Carolina, Pennsylvania, and Virginia, respectively. We found disproportionate health burden associated with AFO/CAFO exposure in some subpopulations, however results varied by state. Our findings provide evidence of higher mortality risk with high AFO/CAFO exposure, with some populations facing disproportionate health burden, although such relationships differed by location.
; Bell, Michelle L