Caregiver-perceived neighborhood safety and pediatric asthma severity: 2017-2018 National Survey of Children's Health
Department of Population and Quantitative Health Sciences; Department of Surgery; Department of Pediatrics, Division of Pediatric Pulmonology; Graduate School of Biomedical Sciences
Immune System Diseases | Pediatrics | Pulmonology | Respiratory Tract Diseases
OBJECTIVE: To examine the association between caregiver-perceived neighborhood safety and pediatric asthma severity using a cross-sectional, nationally representative sample.
STUDY DESIGN: Using data from the 2017-2018 National Survey of Children's Health, children aged 6-17 years with primary caregiver report of a current asthma diagnosis were included (unweighted N = 3209; weighted N = 3,909,178). Perceived neighborhood safety, asthma severity (mild vs. moderate/severe), demographic, household, and health/behavioral covariate data were collected from primary caregiver report. Poisson regression with robust error variance was used to estimate the association between perceived neighborhood safety and caregiver-reported pediatric asthma severity.
RESULTS: Approximately one-third of children studied had moderate/severe asthma. A total of 42% of children with mild asthma and 52% of children with moderate/severe asthma identified as Hispanic or non-Hispanic Black. Nearly 20% of children with mild asthma and 40% of children with moderate/severe asthma were from families living below the federal poverty level (FPL). Children living in neighborhoods perceived by their caregiver to be unsafe had higher prevalence of moderate/severe asthma compared to those in the safest neighborhoods (adjusted prevalence ratio: 1.34; 95% confidence interval: 1.04-1.74). This association was found to be independent of race/ethnicity, household FPL, household smoking, and child's physical activity level after adjusting for covariates.
CONCLUSIONS: Children living in neighborhoods perceived by their caregiver to be unsafe have higher prevalence of moderate or severe asthma. Further investigation of geographic context and neighborhood characteristics that influence childhood asthma severity may inform public health strategies to reduce asthma burden and improve disease outcomes.
NSCH, association, child, childhood, cross-sectional, UMCCTS funding
DOI of Published Version
Hoque S, Goulding M, Hazeltine M, Ferrucci KA, Trivedi M, Liu SH. Caregiver-perceived neighborhood safety and pediatric asthma severity: 2017-2018 National Survey of Children's Health. Pediatr Pulmonol. 2022 Feb;57(2):376-385. doi: 10.1002/ppul.25762. Epub 2021 Nov 23. PMID: 34796705; PMCID: PMC8792337. Link to article on publisher's site
Hoque S, Goulding M, Hazeltine MD, Ferrucci KA, Trivedi MK, Liu S. (2022). Caregiver-perceived neighborhood safety and pediatric asthma severity: 2017-2018 National Survey of Children's Health. UMass Chan Medical School Faculty Publications. https://doi.org/10.1002/ppul.25762. Retrieved from https://escholarship.umassmed.edu/faculty_pubs/2189