Perceived neighborhood safety and asthma morbidity in the school Inner-City Asthma study
Irritable Bowel Syndrome
Primary Health Care
© 2014 Wiley Periodicals, Inc. Aim: The aim of this study was to investigate whether neighborhood safety as perceived by primary caregivers is associated with asthma morbidity outcomes among inner-city school children with asthma.Methods: School children with asthma were recruited from 25 innercity schools between 2009 and 2012 for the School Inner-City Asthma Study (N = 219). Primary caregivers completed a baseline questionnaire detailing their perception of neighborhood safety and their children's asthma symptoms, and the children performed baseline pulmonary function tests. In this cross-sectional analysis, asthma control was compared between children whose caregivers perceived their neighborhood to be unsafe versus safe.Results: After adjusting for potential confounders, those children whose primary caregivers perceived the neighborhood to be unsafe had twice the odds of having poorly controlled asthma (odds ratio [OR] adjusted = 2.2,95% confidence interval [CI] = 1.2-3.9, P = 0.009), four times the odds of dyspnea and rescue medication use (OR adjusted = 4.7; 95% CI = 1.7-13.0, P = 0.003, OR adjusted = 4.0; 95% CI = 1.8-8.8, P< 0.001, respectively), three times as much limitation in activity (OR adjusted = 3.2; 95% CI = 1.4-7.7, P= 0.008), and more than twice the odds of night-time symptoms (OR adjusted = 2.2; 95% CI = 1.3-4.0, P= 0.007) compared to participants living in safe neighborhoods. There was no difference in pulmonary function test results between the two groups.Conclusions: Primary caregivers' perception of neighborhood safety is associated with childhood asthma morbidity among inner-city school children with asthma. Further study is needed to elucidate mechanisms behind this association, and future intervention studies to address social disadvantage may be important.
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