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The association between contextual socioeconomic factors and prevalent asthma in a cohort of Southern California school children

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  • Shankardass, Ketan
  • McConnell, Rob S.
  • Milam, Joel
  • Berhane, Kiros
  • Tatalovich, Zaria
  • Wilson, John P.
  • Jerrett, Michael

Abstract

Spatial variation in childhood asthma and a recent increase in prevalence indicate that environmental factors play a significant role in the etiology of this important disease. Socioeconomic position (SEP) has been associated inversely and positively with childhood asthma. These contradictory results indicate a need for systematic research about SEP and asthma. Pathways have been suggested for effects of SEP on asthma at both the individual and community level. We examined the relationship of prevalent asthma to community-level indicators of SEP among 5762 children in 12 Southern California communities, using a multilevel random effects model. Estimates of community-level SEP were derived by summarizing census block group-level data using a novel method of weighting by the proportion of the block groups included in a community-specific bounding rectangle that contained 95% of local study subjects. Community characteristics included measures of male unemployment, household income, low education (i.e., no high school diploma) and poverty. There was a consistent inverse association between male unemployment and asthma across the inter-quartile range of community unemployment rates, indicating that asthma rates increase as community SEP increases. The results were robust to individual-level confounding, methods for summarizing census block group data to the community level, scale of analysis (i.e., community-level vs. neighborhood-level) and the modeling algorithm. The positive association between SEP and prevalent childhood asthma might be explained by differential access to medical care that remains unmeasured, by the hygiene hypothesis (e.g., lower SES may associate with higher protective exposures to endotoxin in early life), or by SEP acting as a proxy for unmeasured neighborhood characteristics.

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  • Shankardass, Ketan & McConnell, Rob S. & Milam, Joel & Berhane, Kiros & Tatalovich, Zaria & Wilson, John P. & Jerrett, Michael, 2007. "The association between contextual socioeconomic factors and prevalent asthma in a cohort of Southern California school children," Social Science & Medicine, Elsevier, vol. 65(8), pages 1792-1806, October.
    • Handle: RePEc:eee:socmed:v:65:y:2007:i:8:p:1792-1806
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    1. Emanuel Alcala & Paul Brown & John A. Capitman & Mariaelena Gonzalez & Ricardo Cisneros, 2019. "Cumulative Impact of Environmental Pollution and Population Vulnerability on Pediatric Asthma Hospitalizations: A Multilevel Analysis of CalEnviroScreen," IJERPH, MDPI, vol. 16(15), pages 1-12, July.
    2. Eum, Youngseob & Yoo, EunHye & Bowen, Elizabeth, 2019. "Socioeconomic determinants of pediatric asthma emergency department visits under regional economic development in western New York," Social Science & Medicine, Elsevier, vol. 222(C), pages 133-144.
    3. Janvier Gasana & Boubakari Ibrahimou & Ahmed N. Albatineh & Mustafa Al-Zoughool & Dina Zein, 2021. "Exposures in the Indoor Environment and Prevalence of Allergic Conditions in the United States of America," IJERPH, MDPI, vol. 18(9), pages 1-13, May.
    4. Timothy W. Collins & Young-an Kim & Sara E. Grineski & Stephanie Clark-Reyna, 2014. "Can Economic Deprivation Protect Health? Paradoxical Multilevel Effects of Poverty on Hispanic Children’s Wheezing," IJERPH, MDPI, vol. 11(8), pages 1-18, August.
    5. Tyler P. Pittman & Candace I. J. Nykiforuk & Javier Mignone & Piush J. Mandhane & Allan B. Becker & Anita L. Kozyrskyj, 2012. "The Association Between Community Stressors and Asthma Prevalence of School Children in Winnipeg, Canada," IJERPH, MDPI, vol. 9(2), pages 1-17, February.

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