Racial/ethnic disparities in disease burden and costs related to exposure to endocrine-disrupting chemicals in the United States: an exploratory analysis

J Clin Epidemiol. 2019 Apr;108:34-43. doi: 10.1016/j.jclinepi.2018.11.024. Epub 2018 Dec 7.


Objective: Studies have documented disparities in exposure to endocrine-disrupting chemicals (EDC), but no studies have investigated potential implications for racial/ethnic disparities in chronic disease and associated costs. Our objective was to examine EDC levels in the US population according to race/ethnicity and to quantify disease burden and associated costs.

Study design and setting: EDC exposure levels in 2007-2010 were obtained from the National Health and Nutrition Examination Surveys. The associated disease burden and costs for 12 exposure-response relationships were determined for non-Hispanic Whites, non-Hispanic Blacks, Mexican Americans, Other Hispanics, and Other/Multicultural.

Results: EDC exposure levels and associated burden of disease and costs were higher in non-Hispanic Blacks ($56.8 billion; 16.5% of total costs) and Mexican Americans ($50.1 billion; 14.6%) compared with their proportion of the total population (12.6% and 13.5%, respectively). Associated costs among non-Hispanic whites comprised 52.3% of total costs ($179.8 billion) although they comprise 66.1% of the US population. These disparities are driven by generally higher exposure to persistent pesticides and flame retardants among non-Hispanic blacks and Mexican Americans.

Conclusion: Our estimates suggest that racial/ethnic disparities in chronic diseases in the US may be because of chemical exposures and are an important tool to inform policies that address such disparities.

Keywords: Disease burden; Economic costs; Endocrine-disrupting chemicals; Neurodevelopment; Obesity; Reproductive health.

MeSH terms

  • Adult
  • Child
  • Chronic Disease / economics
  • Chronic Disease / epidemiology
  • Chronic Disease / ethnology*
  • Cost of Illness
  • Endocrine Disruptors / poisoning*
  • Environmental Exposure / analysis
  • Environmental Exposure / economics
  • European Continental Ancestry Group / statistics & numerical data
  • Female
  • Health Status Disparities*
  • Hispanic Americans / statistics & numerical data
  • Humans
  • Male
  • United States / epidemiology


  • Endocrine Disruptors