Dataset Information

The influence of neighborhood environment on the incidence of childhood asthma: a propensity score approach.

ABSTRACT:

Background

The propensity score method has been underused in research concerning asthma epidemiology, which is useful for addressing covariate imbalance in observational studies.

Objective

To examine the impact of neighborhood environment on asthma incidence by applying the propensity score method.

Methods

The study was designed as a retrospective cohort study. Study subjects were all children born in Rochester, Minn, between 1976 and 1979. Asthma status was previously determined by applying predetermined criteria. We applied the propensity score method to match children who lived in census tracts facing or not facing intersections with major highways or railroads. The propensity score of children living in a census tract facing intersections was formulated from a logistic regression model with 16 variables that may not be balanced between comparison groups. The Cox proportional hazard models were used in the matched samples to estimate hazard ratios of neighborhood environment and some other variables of interest and their corresponding 95% CIs.

Results

After matching with propensity scores, we found that children who lived in census tracts facing intersections with major highways or railroads had a higher risk of asthma (hazard ratios, 1.385-1.669 depending on the matching methods) compared with the matched counterparts who lived in census tracts not facing intersections with major highways or railroads.

Conclusion

Neighborhood environment may be an important risk factor in understanding the development of pediatric asthma. The propensity score method is a useful tool in addressing covariate imbalance and exploring for causal effect in studying asthma epidemiology.

SUBMITTER: Juhn YJ

PROVIDER: S-EPMC2962617 | biostudies-literature | 2010 Apr

REPOSITORIES: biostudies-literature

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Publications

The influence of neighborhood environment on the incidence of childhood asthma: a propensity score approach.

Juhn Young J YJ Qin Rui R Urm Sanghwa S Katusic Slavica S Vargas-Chanes Delfino D

The Journal of allergy and clinical immunology 20100317 4

<h4>Background</h4>The propensity score method has been underused in research concerning asthma epidemiology, which is useful for addressing covariate imbalance in observational studies.<h4>Objective</h4>To examine the impact of neighborhood environment on asthma incidence by applying the propensity score method.<h4>Methods</h4>The study was designed as a retrospective cohort study. Study subjects were all children born in Rochester, Minn, between 1976 and 1979. Asthma status was previously dete ...[more]

PMID: 20236695

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Project description:ImportanceIn the United States, Black and Hispanic children have higher rates of asthma and asthma-related morbidity compared with White children and disproportionately reside in communities with economic deprivation.ObjectiveTo determine the extent to which neighborhood-level socioeconomic indicators explain racial and ethnic disparities in childhood wheezing and asthma.Design, setting, and participantsThe study population comprised children in birth cohorts located throughout the United States that are part of the Children's Respiratory and Environmental Workgroup consortium. Cox proportional hazard models were used to estimate hazard ratios (HRs) of asthma incidence, and logistic regression was used to estimate odds ratios of early and persistent wheeze prevalence accounting for mother's education, parental asthma, smoking during pregnancy, child's race and ethnicity, sex, and region and decade of birth.ExposuresNeighborhood-level socioeconomic indicators defined by US census tracts calculated as z scores for multiple tract-level variables relative to the US average linked to participants' birth record address and decade of birth. The parent or caregiver reported the child's race and ethnicity.Main outcomes and measuresPrevalence of early and persistent childhood wheeze and asthma incidence.ResultsOf 5809 children, 46% reported wheezing before age 2 years, and 26% reported persistent wheeze through age 11 years. Asthma prevalence by age 11 years varied by cohort, with an overall median prevalence of 25%. Black children (HR, 1.47; 95% CI, 1.26-1.73) and Hispanic children (HR, 1.29; 95% CI, 1.09-1.53) were at significantly increased risk for asthma incidence compared with White children, with onset occurring earlier in childhood. Children born in tracts with a greater proportion of low-income households, population density, and poverty had increased asthma incidence. Results for early and persistent wheeze were similar. In effect modification analysis, census variables did not significantly modify the association between race and ethnicity and risk for asthma incidence; Black and Hispanic children remained at higher risk for asthma compared with White children across census tracts socioeconomic levels.Conclusions and relevanceAdjusting for individual-level characteristics, we observed neighborhood socioeconomic disparities in childhood wheeze and asthma. Black and Hispanic children had more asthma in neighborhoods of all income levels. Neighborhood- and individual-level characteristics and their root causes should be considered as sources of respiratory health inequities.

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Dataset Information

The influence of neighborhood environment on the incidence of childhood asthma: a propensity score approach.

Background

Objective

Methods

Results

Conclusion

Publications

The influence of neighborhood environment on the incidence of childhood asthma: a propensity score approach.

Similar Datasets

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