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Cantuaria ML, Brandt J, Blanes-Vidal V. Exposure to multiple environmental stressors, emotional and physical well-being, and self-rated health: An analysis of relationships using latent variable structural equation modelling. ENVIRONMENTAL RESEARCH 2023; 227:115770. [PMID: 37003553 DOI: 10.1016/j.envres.2023.115770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/10/2023] [Accepted: 03/23/2023] [Indexed: 05/08/2023]
Affiliation(s)
- Manuella Lech Cantuaria
- Applied AI and Data Science, The Maersk Mc-Kinney Moller Institute, University of Southern Denmark, Odense, Denmark.
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Victoria Blanes-Vidal
- Applied AI and Data Science, The Maersk Mc-Kinney Moller Institute, University of Southern Denmark, Odense, Denmark
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Tabalipa FDO, Daitx RB, Traebert JL, Meyer AS, da Silva J. Indicators of violence and asthma: An ecological study. Allergol Int 2015; 64:344-50. [PMID: 26433530 DOI: 10.1016/j.alit.2015.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 04/02/2015] [Accepted: 04/03/2015] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Global studies on asthma point to socioeconomic status as one of the main variables in terms of prevalence and disease severity in various parts of the world. Social factors related to community violence have been linked to higher incidence of asthma in the current studies. This study investigates the relationship between indicators of both community violence and development and hospital admissions due to asthma. METHODS This was an analytical ecological study of multiple groups, using public databases with information up until 2006. All Brazilian municipalities with more than 100,000 inhabitants were considered as units of analysis. The main index used as socioeconomic indicator was the FIRJAN Index of Municipal Development (FIMD). The Index of Youth Vulnerability to Violence (IYVV) was used as indicators of community violence. The rate of admissions due to asthma was used as the outcome. Pearson's correlation was used for multivariate analyses. The coefficient of determination (R(2)) was calculated and the simple linear regression model adjusted for significant correlations. RESULTS There was an inverse correlation between asthma admissions and FIMD (r = -0.354, p < 0.001), with statistical significance for all dimensions of the index. Admissions due to asthma were associated with the IYVV (r = 0.240, p < 0.001) and its component related to school attendance and employment (r = 0.315, p < 0.001), homicides (r = 0.112, p = 0.034), and poverty (r = 0.303, p < 0.001). CONCLUSIONS There was a direct correlation between indicators of violence and rates of admission due asthma, and an inverse correlation with indicators of development. These results suggest that social detriment can act as a risk factor for hospital admissions due to asthma.
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Affiliation(s)
| | | | - Jefferson Luiz Traebert
- Medicine Course, University of Southern Santa Catarina (UNISUL), Palhoça, Brazil; Postgraduate Program in Health Sciences, UNISUL, Palhoça, Brazil
| | | | - Jane da Silva
- Medicine Course, University of Southern Santa Catarina (UNISUL), Palhoça, Brazil; Postgraduate Program in Health Sciences, UNISUL, Palhoça, Brazil.
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Neighborhood-health links: Differences between rural-to-urban migrants and natives in Shanghai. DEMOGRAPHIC RESEARCH 2015. [DOI: 10.4054/demres.2015.33.17] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Gariepy G, Blair A, Kestens Y, Schmitz N. Neighbourhood characteristics and 10-year risk of depression in Canadian adults with and without a chronic illness. Health Place 2014; 30:279-86. [PMID: 25453748 DOI: 10.1016/j.healthplace.2014.10.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 10/08/2014] [Accepted: 10/21/2014] [Indexed: 11/17/2022]
Abstract
The neighbourhood environment could play a role in the risk of depression in adults and those with a chronic illness. We investigated the effects of a range of neighbourhood characteristics on the 10-year risk of depression in a representative sample of 9026 Canadian adults and subsamples with a chronic condition. Characteristics of neighbourhoods were not significantly related to the risk of depression in the general sample and subsamples with a chronic condition. However, residing near a park was significantly associated with a lower risk of depression for people living in crowded households, and having a local health service nearby was protective for those living in materially deprived neighbourhoods. Living in a neighbourhood that was both socially advantaged and offered cultural services was also associated with lower risk of depression. Additional research is needed for smaller effect size detection. Future intervention research is warranted for health policy recommendations.
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Affiliation(s)
- Genevieve Gariepy
- Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada.
| | - Alexandra Blair
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Yan Kestens
- Department of Social and Preventative Medicine, University of Montreal, Montreal, QC, Canada
| | - Norbert Schmitz
- Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada; Department of Psychiatry, McGill University, Montreal, QC, Canada
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Jiang M, Qin P, Yang X. Comorbidity between depression and asthma via immune-inflammatory pathways: a meta-analysis. J Affect Disord 2014; 166:22-9. [PMID: 25012406 DOI: 10.1016/j.jad.2014.04.027] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 04/07/2014] [Accepted: 04/12/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND Depression is often present in patients with asthma and vice versa. In this review, we aimed to summarize reports on the comorbidity of depression and asthma, and to seek evidence that the biological mechanisms of allergy may have an important role linking asthma and depression. METHOD To explore the relationship and pathway underpinning this comorbidity, we reviewed medical articles and undertook a meta-analysis of epidemiological studies on (i) incidence of asthma in patients with depression; (ii) morbidity of depression in patients with asthma; (iii) concentration of cytokines in depressed subjects. RESULTS High level of comorbidity of asthma and depression was consistently demonstrated in 10 studies of patients with asthma and four studies of patients with depression. In search of biological connection of the two illnesses, thirty-eight studies were included for Meta-analyses examining differences in allergy related cytokines between patients with depression and non-depressive subjects. In people with depression, concentration of monocytes related cytokines such as IL-1 (1.56ng/mL, 95% CI: 0.00-3.12, p=0.05) was significantly higher than that in non-depressive control subjects. At the same time, some other inflammatory factors including IL-4 (5.77pg/mL, 95% CI: 2.34-9.21, p=0.00010), IL-6 (1.44ng/mL, 95% CI: 1.05-1.82, p<0.00001) and TNF-α(3.01ng/mL, 95% CI: 1.76-4.26, p<0.00001) were extremely significantly higher in depressed people compared with the controls. There was no significant differences of the T cell related cytokine levels, IFN-γ (-0.16ng/mL, 95% CI: -0.85-7.73, p=0.97), accompanied with IL-10 (0.67ng/mL, 95% CI: -0.84-2.18, p=0.38) between depressive and non-depressive groups. CONCLUSIONS The varying levels of certain cytokines play an important role in arousing and remitting asthma and depression. That suggests inflammatory response could be a common pathway adjusting both depression and asthma.
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Affiliation(s)
- Mingdi Jiang
- Section of Environmental Biomedicine, Hubei Key Laboratory of Genetic Regulation and Integrative Biology, College of Life Sciences, Central China Normal University, Wuhan 430079, China
| | - Ping Qin
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Xu Yang
- Section of Environmental Biomedicine, Hubei Key Laboratory of Genetic Regulation and Integrative Biology, College of Life Sciences, Central China Normal University, Wuhan 430079, China.
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Euteneuer F, Mills PJ, Pung MA, Rief W, Dimsdale JE. Neighborhood problems and nocturnal blood pressure dipping. Health Psychol 2013; 33:1366-72. [PMID: 24245839 DOI: 10.1037/hea0000004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Living in adverse neighborhood conditions has been linked with greater prevalence of cardiovascular disease (CVD). We aimed to learn whether perceived neighborhood problems are related to attenuated nocturnal blood pressure (BP) dipping, a risk factor for CVD morbidity. METHOD A sample of 133 adults (71 male, 62 female; 80 White, 53 Black) underwent 24-hr ambulatory blood pressure monitoring. The neighborhood problem scale (NPS) was used to assess neighborhood environmental stressors. RESULTS Nocturnal dipping in systolic (SBP), diastolic (DBP) and mean arterial (MAP) blood pressure was reduced in individuals with higher NPS scores (p < .05). Hierarchical regression analyses revealed that neighborhood problems explained 4%-6% of the variance in SBP, DBP, and MAP dipping (p < .05) even after adjusting for several theoretical confounders such as social status, age, gender, race, body mass index (BMI), smoking, exercise, depression and discrimination. CONCLUSION Neighborhood problems may contribute to attenuated BP dipping beyond the effect of known risk factors.
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Affiliation(s)
- Frank Euteneuer
- Department of Psychiatry, University of California, San Diego
| | - Paul J Mills
- Department of Psychiatry, University of California, San Diego
| | - Meredith A Pung
- Department of Psychiatry, University of California, San Diego
| | - Winfried Rief
- Division of Clinical Psychology and Psychotherapy, Philipps Universität
| | - Joel E Dimsdale
- Department of Psychiatry, University of California, San Diego
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Li T, Lin G. Examining the role of location-specific associations between ambient air pollutants and adult asthma in the United States. Health Place 2013; 25:26-33. [PMID: 24216026 DOI: 10.1016/j.healthplace.2013.10.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Revised: 10/14/2013] [Accepted: 10/20/2013] [Indexed: 11/18/2022]
Abstract
This study examined the association between ozone and fine particulate (PM2.5) exposure and asthma risk by place of residence. We linked 412,832 adult respondents from the 2009 U.S. Behavioral Risk Factor Surveillance System to their residence counties. Observed and interpolated ozone and PM2.5 concentration data from 2006 to 2009 were used as exposures. We linked self-reported current asthma status and other individual risk factors to county-level risk factors in multilevel logistic regressions. Results indicated spatially varied asthma risks and spatially varied associations between ambient air pollution and asthma risk. Residents in counties not located within a metropolitan statistical area (MSA) and in inner ring suburbs had a relatively higher asthma risk. Positive ozone-asthma associations were detected across all spatial settings, while positive PM2.5-asthma associations were detected only in central cities of an MSA and in outer ring suburbs, indicating that residence location modified the relationship between ambient air pollution and asthma risk.
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Affiliation(s)
- Tao Li
- Department of Health Services Research & Administration, College of Public Health, 984350 Nebraska Medical Center, Omaha, NE 68198-4350, USA
| | - Ge Lin
- Department of Health Services Research & Administration, College of Public Health, 984350 Nebraska Medical Center, Omaha, NE 68198-4350, USA.
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Kendzor DE, Businelle MS, Cofta-Woerpel LM, Reitzel LR, Castro Y, Vidrine JI, Mazas CA, Cinciripini PM, Wetter DW. Mechanisms linking socioeconomic disadvantage and BMI in smokers. Am J Health Behav 2013; 37:587-98. [PMID: 23985281 DOI: 10.5993/ajhb.37.5.2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To evaluate a conceptual model of the psychosocial pathways linking socioeconomic status and body mass index (BMI) among smokers. METHODS A latent variable modeling approach was used to evaluate the interrelationships among socioeconomic status, perceived neighborhood disadvantage, social support, negative affect, and BMI among smokers recruited from the Houston metropolitan area (N = 424). RESULTS A total of 42.4% of participants were obese, with the highest prevalence of obesity among Latinos followed by African Americans. Across all racial/ethnic groups, perceived neighborhood disadvantage, social support, and negative affect functioned as pathways linking socioeconomic status and BMI. CONCLUSIONS Findings indicate the need for interventions that target obesity among socioeconomically disadvantaged smokers and provide potential intervention targets for the prevention and treatment of obesity.
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Affiliation(s)
- Darla E Kendzor
- The University of Texas Health Science Center, School of Public Health, UT Southwestern Harold C. Simmons Comprehensive Cancer Center, Population Science and Cancer Control Program, Dallas, TX, USA.
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Sampson NR, Parker EA, Cheezum RR, Lewis TC, O'Toole A, Patton J, Zuniga A, Robins TG, Keirns CC. A life course perspective on stress and health among caregivers of children with asthma in Detroit. FAMILY & COMMUNITY HEALTH 2013; 36:51-62. [PMID: 23168346 PMCID: PMC3984896 DOI: 10.1097/fch.0b013e31826d7620] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Low-income caregivers raising children with asthma experience many obstacles to their own health, including stress. To understand and describe their daily experiences, researchers conducted 40 qualitative interviews supplemented with descriptive quantitative surveys in Detroit, Michigan, as part of a community-based participatory research partnership of Community Action Against Asthma. Prevalence of chronic illness is noticeably higher among participants than the general US population. Caregivers identified stress processes that may influence disproportionate health outcomes and risk-related behaviors over their lifetime. Applying a life course perspective, findings suggest that public health interventions should address family-level comorbidities, increase instrumental social support, and acknowledge practical coping mechanisms.
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Affiliation(s)
- Natalie R Sampson
- Department of Health Behavior Health Education, University of Michigan, Ann Arbor, MI, USA.
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Trupin L, Katz PP, Balmes JR, Chen H, Yelin EH, Omachi T, Blanc PD. Mediators of the socioeconomic gradient in outcomes of adult asthma and rhinitis. Am J Public Health 2012; 103:e31-8. [PMID: 23237178 DOI: 10.2105/ajph.2012.300938] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We estimated the extent to which socioeconomic status (SES) gradients in adult asthma and rhinitis outcomes can be explained by home and neighborhood environmental factors. METHODS Using survey data for 515 adults with either asthma or rhinitis, or both, we examined environmental mediators of SES associations with disease severity, using the Severity of Asthma Scale, and health-related quality of life (HRQL), using the Rhinasthma Scale. We defined SES on the basis of education and household income. Potential environmental mediators included home type and ownership, exposures to allergens and irritants, and a summary measure of perceived neighborhood problems. We modeled each outcome as a function of SES, and controlled for age, gender, and potential mediators. RESULTS Gradients in SES were apparent in disease severity and HRQL. Living in a rented house partially mediated the SES gradient for both severity and HRQL (P < .01). Higher perceived levels of neighborhood problems were associated with poorer HRQL and partially mediated the income-HRQL relationship (P < .01). CONCLUSIONS Differences in home and neighborhood environments partially explained associations of SES with adult asthma and rhinitis outcomes.
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Affiliation(s)
- Laura Trupin
- Department of Medicine, University of California, San Francisco, CA 94143-0920, USA.
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Yen IH, Anderson LA. Built environment and mobility of older adults: important policy and practice efforts. J Am Geriatr Soc 2012; 60:951-6. [PMID: 22568533 DOI: 10.1111/j.1532-5415.2012.03949.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
As people age, they prefer to "age in place." The concept of aging in place refers to the ability to live in one's own home, wherever that might be, for as long as one can feel confident and comfortable. Where people live and whether these environments can support them are critical questions for public health and public policy, especially since the baby boomers began to turn 65 on January 1, 2011. Equally important for public policy, those aged 85 and older are the fastest growing population group in the United States. The Health and Aging Policy Fellows Program, with the Centers for Disease Control and Prevention Healthy Aging Program, has supported a project to determine how design features of the built environment can support the mobility of older adults. Mobility refers to physical activity, usually walking, but also encompasses the ability to stay connected to nearby community resources and services. The project's purpose is to investigate features that support mobility in built environments. This policy brief introduces the realist synthesis method used in the project and selected national initiatives and activities to place this work in a broader context. Given the importance of mobility concerns to older adults, it must be determined without delay which design features support mobility and how local areas can better prepare to support the health of their aging populations.
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Affiliation(s)
- Irene H Yen
- Department of Medicine, University of California at San Francisco, San Francisco, California 94118, USA.
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Home is where the HAART is: an examination of factors affecting neighbourhood perceptions among people with HIV/AIDS on antiretroviral therapy. AIDS Care 2011; 23:245-51. [DOI: 10.1080/09540121.2010.490256] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Martin KR, Shreffler J, Schoster B, Callahan LF. Associations of perceived neighborhood environment on health status outcomes in persons with arthritis. Arthritis Care Res (Hoboken) 2010; 62:1602-11. [PMID: 20521309 DOI: 10.1002/acr.20267] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Accepted: 05/24/2010] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine the association between 4 aspects of perceived neighborhood environment (aesthetics, walkability, safety, and social cohesion) and health status outcomes in a cohort of North Carolinians with self-reported arthritis after adjustment for individual and neighborhood socioeconomic status covariates. METHODS In a telephone survey, 696 participants self-reported ≥1 types of arthritis or rheumatic conditions. Outcomes measured were physical and mental functioning (Short Form 12 health survey version 2 physical component and mental component summary [MCS]), functional disability (Health Assessment Questionnaire), and depressive symptomatology (Center for Epidemiologic Studies Depression Scale scores <16 versus ≥16). Multivariate regression and multivariate logistic regression analyses were conducted using Stata, version 11. RESULTS Results from separate adjusted models indicated that measures of associations for perceived neighborhood characteristics were statistically significant (P ≤ 0.001 to P = 0.017) for each health status outcome (except walkability and MCS) after adjusting for covariates. Final adjusted models included all 4 perceived neighborhood characteristics simultaneously. A 1-point increase in perceiving worse neighborhood aesthetics predicted lower mental health (B = -1.81, P = 0.034). Individuals had increased odds of depressive symptoms if they perceived lower neighborhood safety (odds ratio [OR] 1.36, 95% confidence interval [95% CI] 1.04-1.78; P = 0.023) and lower neighborhood social cohesion (OR 1.42, 95% CI 1.03-1.96; P = 0.030). CONCLUSION Study findings indicate that an individual's perception of neighborhood environment characteristics, especially aesthetics, safety, and social cohesion, is predictive of health outcomes among adults with self-reported arthritis, even after adjusting for key variables. Future studies interested in examining the role that community characteristics play on disability and mental health in individuals with arthritis might consider further examination of perceived neighborhood environment.
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Wu XY, Ohinmaa A, Veugelers PJ. Sociodemographic and neighbourhood determinants of health-related quality of life among grade-five students in Canada. Qual Life Res 2010; 19:969-76. [DOI: 10.1007/s11136-010-9663-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2010] [Indexed: 11/28/2022]
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Balmes JR, Earnest G, Katz PP, Yelin EH, Eisner MD, Chen H, Trupin L, Lurmann F, Blanc PD. Exposure to traffic: lung function and health status in adults with asthma. J Allergy Clin Immunol 2009; 123:626-31. [PMID: 19152968 DOI: 10.1016/j.jaci.2008.10.062] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2008] [Revised: 09/25/2008] [Accepted: 10/29/2008] [Indexed: 11/30/2022]
Abstract
BACKGROUND Exposure to traffic has been associated with asthma outcomes in children, but its effect on asthma in adults has not been well studied. OBJECTIVE To test the hypothesis that lung function and health status are associated with traffic exposures. METHODS We measured FEV(1) % predicted, general health status using the Physical Component Scale of the 12-item Short Form (SF-12 PCS), and quality of life (QoL) using the Marks Asthma Quality of Life questionnaire in a cohort of adults with asthma or rhinitis (n = 176; 145 with asthma). We assessed exposures to traffic by geocoding subjects' residential addresses and assigning distance to roadways. Associations between distance to nearest roadway and distance to nearest major roadway and FEV(1) % predicted or SF-12 PCS were studied by using linear regression. RESULTS FEV(1) % predicted was positively associated with distance from both nearest roadway (P = .01) and nearest major roadway (P = .02). SF-12 PCS and QoL were not significantly associated with either traffic variable. Adjustment for income, smoking, and obesity did not substantively change the associations of the traffic variables with FEV(1) % predicted (P = .04 for nearest roadway and P = .02 for nearest major roadway) and did not cause associations with either SF-12 PCS or QoL to become significant. CONCLUSIONS Traffic exposure was associated with decreased lung function in adults with asthma.
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Affiliation(s)
- John R Balmes
- Department of Medicine, University of California-San Francisco, San Francisco, Calif 94143-0843, USA.
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Chen E, Schreier HMC. Does the social environment contribute to asthma? Immunol Allergy Clin North Am 2008; 28:649-64, x. [PMID: 18572112 DOI: 10.1016/j.iac.2008.03.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The impact of the social environment on asthma has recently begun to receive increasing attention. This article reviews the current literature to investigate the impact of the social environment at three levels-the neighborhood level, the peer level, and the family level-and to explore pathways through which the social environment "gets under the skin" to impact asthma onset and morbidity. Research to date suggests that adverse social conditions at the neighborhood and family levels impact asthma morbidity through direct effects on physiologic systems as well as by altering health behaviors. The impact on asthma of social networks, such as friendships, is less clear and will need to be investigated further. Future research will need to take into account the impact of the social environment to develop more comprehensive models of asthma pathogenesis.
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Affiliation(s)
- Edith Chen
- Department of Psychology, University of British Columbia,Vancouver, British Columbia V6T 1Z4, Canada.
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Quinlan PJ, Earnest G, Eisner MD, Yelin EH, Katz PP, Balmes JR, Blanc PD. Performance of self-reported occupational exposure compared to a job-exposure matrix approach in asthma and chronic rhinitis. Occup Environ Med 2008; 66:154-60. [PMID: 18805880 DOI: 10.1136/oem.2008.040022] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Self-reported exposure to vapours, gas, dust or fumes (VGDF) has been widely used as an occupational exposure metric in epidemiological studies of chronic lung diseases. Our objective was to characterise the performance of VGDF for repeatability, systematic misclassification, and sensitivity and specificity against exposure likelihood by a job-exposure matrix (JEM). METHODS We analysed data from two interviews, 24 months apart, of adults with asthma and chronic rhinitis. Using distinct job as the unit of analysis, we tested a single response item (exposure to VGDF) against assignment using a JEM. We further analysed VGDF and the JEM among a subset of 199 subjects who reported the same job at both interviews, using logistic regression analysis to test factors associated with VGDF inconsistency and discordance with the JEM. RESULTS VGDF was reported for 193 (44%) of 436 distinct jobs held by the 348 subjects studied; moderate to high exposure likelihood by JEM was assigned to 120 jobs (28%). The sensitivity and specificity of VGDF against JEM were 71% and 66%, respectively. Among 199 subjects with the same job at both interviews, 32% had a discordant VGDF status (kappa = 0.35). Those with chronic rhinitis without concomitant asthma compared to asthma alone were more likely to have a VGDF report discordant with the JEM (OR 3.6, 95% CI 1.4 to 9.0; p = 0.01). Rhinitis was also associated with reported VGDF in a job classified by the JEM as low exposure (OR 3.9, 95% CI 1.6 to 9.4; p = 0.003). CONCLUSION The VGDF item is moderately sensitive measured against JEM as a benchmark. The measure is a useful assessment method for epidemiological studies of occupational exposure risk.
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Affiliation(s)
- P J Quinlan
- Division of Occupational and Environmental Medicine, University of California San Francisco, 1001 Potrero Avenue, San Francisco, CA 94110, USA.
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Schulz AJ, Zenk SN, Israel BA, Mentz G, Stokes C, Galea S. Do neighborhood economic characteristics, racial composition, and residential stability predict perceptions of stress associated with the physical and social environment? Findings from a multilevel analysis in Detroit. J Urban Health 2008; 85:642-61. [PMID: 18481182 PMCID: PMC2527427 DOI: 10.1007/s11524-008-9288-5] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2008] [Accepted: 04/23/2008] [Indexed: 11/28/2022]
Abstract
As the body of evidence linking disparities in the health of urban residents to disparate social, economic and environmental contexts grows, efforts to delineate the pathways through which broader social and economic inequalities influence health have burgeoned. One hypothesized pathway connects economic and racial and ethnic inequalities to differentials in stress associated with social and physical environments, with subsequent implications for health. Drawing on data from Detroit, Michigan, we examined contributions of neighborhood-level characteristics (e.g., poverty rate, racial and ethnic composition, residential stability) and individual-level characteristics (e.g., age, gender) to perceived social and physical environmental stress. We found that neighborhood percent African American was positively associated with perceptions of both social and physical environmental stress; neighborhood percent poverty and percent Latino were positively associated with perceived physical environmental stress; and neighborhood residential stability was negatively associated with perceived social environmental stress. At the individual level, whites perceived higher levels of both social and physical environmental stress compared to African American residents of the same block groups, after accounting for other variables included in the models. Our findings suggest the importance of understanding and addressing contributions of neighborhood structural characteristics to perceptions of neighborhood stress. The consistency of the finding that neighborhood racial composition and individual-level race influence perceptions of both social and physical environments suggests the continuing importance of understanding the role played by structural conditions and by personal and collective histories that vary systematically by race and ethnicity within the United States.
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Affiliation(s)
- Amy J Schulz
- University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA.
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