Investigating the Relationships among Neighborhood Factors and Asthma Control in African American Children
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Date
2019-02-07
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Johns Hopkins University
Abstract
Racial and socioeconomic disparities in childhood asthma have been partially attributed to differential neighborhood exposures associated with poverty. Greenspace, or land with grass, trees or other vegetation, is a modifiable neighborhood exposure that may improve asthma control. However, living in unsafe neighborhoods may limit the potential benefits of greenspace. This study examined associations among neighborhood greenspace, neighborhood safety, and asthma control in a sample of low-income, predominantly African American children (age 3-12) diagnosed with uncontrolled asthma in Baltimore (n=196).
Primary hypotheses were: 1) more neighborhood greenspace would be associated with better asthma control; 2) lower neighborhood safety (i.e., violent crime victimization rate, perceived neighborhood safety) would be associated with poorer asthma control; and 3) neighborhood safety would moderate the relationship between greenspace and level of asthma control. Multivariable logistic regression models were used to test study hypotheses, controlling for demographic, social, and environmental risk factors.
Most of the sample children were African American (95%), male (65%), insured by Medicaid (95%), exposed to secondhand smoke (59%), and diagnosed with very poorly controlled asthma (55%). Results did not support hypotheses 1, 2, or 3. Limited sample size and variability may have influenced these results. Additional analyses demonstrated significant interactions between secondhand smoke and exposure to greenspace and violence.
This study demonstrates the complexity of measuring neighborhood factors and their relationships. Future research in this area should incorporate a larger sample size with greater variability and a longitudinal design.
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Keywords
childhood asthma, greenspace, social determinants of health, neighborhoods, African American, Baltimore, neighborhood safety, poverty, racial disparity, stress, urban poverty, violence