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Perception of Neighborhood Safety and Reported Childhood Lifetime Asthma in the United States (U.S.): A Study Based on a National Survey

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  • S V Subramanian
  • Malinda H Kennedy

Abstract

Background: Recent studies have emphasized the role of psychosocial stressors as a determinant of asthma, and neighborhoods can be a potential source of such stressors. We investigated the association between parental perception of neighborhood safety and reported lifetime asthma among children. Methodology/Principal Findings: Data for the study came from the 2003–04 National Survey of Children Health (NSCH); a nationally representative cross-sectional sample of children aged 0–17 years. Demographic, socioeconomic and behavioral covariates were included in the study. Models were estimated after taking account of weighting and complex survey design. Parental report of whether the child has ever been diagnosed with asthma by a physician was used to define the outcome. Parental report of perception of neighborhood safety was the main exposure. In unadjusted models, the odds ratio (OR) for reporting asthma associated with living in neighborhoods that were perceived to be sometimes or never safe was 1.36 (95% confidence intervals [CI] 1.21, 1.53) compared to living in neighborhoods that were perceived to be always safe. Adjusting for covariates including exposure to second hand tobacco smoke, mother's self-rated health, child's physical activity and television viewing attenuated this association (OR 1.25, 95% CI 1.08, 1.43). In adjusted models, the increased odds ratio for reporting asthma was also higher among those who perceived neighborhoods as being usually safe (OR 1.15 95% CI 1.06, 1.26), as compared to always safe, suggestive of a dose-response relationship, with the differentials for usually safe and never safe being statistically significant (p = 0.009). Conclusion: Psychosocial stressors may be important risk factors that may impact the pathogenesis of asthma and/or contribute to asthma morbidity by triggering exacerbations through neuroimmunologic mechanisms, as well as social mechanisms.

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  • S V Subramanian & Malinda H Kennedy, 2009. "Perception of Neighborhood Safety and Reported Childhood Lifetime Asthma in the United States (U.S.): A Study Based on a National Survey," PLOS ONE, Public Library of Science, vol. 4(6), pages 1-7, June.
    • Handle: RePEc:plo:pone00:0006091
    DOI: 10.1371/journal.pone.0006091
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    References listed on IDEAS

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    1. Wright, R.J. & Mitchell, H. & Visness, C.M. & Cohen, S. & Stout, J. & Evans, R. & Gold, D.R., 2004. "Community Violence and Asthma Morbidity: The Inner-City Asthma Study," American Journal of Public Health, American Public Health Association, vol. 94(4), pages 625-632.
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    1. George Galster & Anna Santiago, 2017. "Neighbourhood ethnic composition and outcomes for low-income Latino and African American children," Urban Studies, Urban Studies Journal Limited, vol. 54(2), pages 482-500, February.
    2. Xiaoqi Feng & Thomas Astell-Burt, 2017. "Is Neighborhood Green Space Protective against Associations between Child Asthma, Neighborhood Traffic Volume and Perceived Lack of Area Safety? Multilevel Analysis of 4447 Australian Children," IJERPH, MDPI, vol. 14(5), pages 1-11, May.
    3. Marlene Camacho-Rivera & Ichiro Kawachi & Gary G Bennett & S V Subramanian, 2014. "Perceptions of Neighborhood Safety and Asthma among Children and Adolescents in Los Angeles: A Multilevel Analysis," PLOS ONE, Public Library of Science, vol. 9(1), pages 1-7, January.

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