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Neighborhood Environment and Asthma Exacerbation in Washington, DC
Annual Review of Nursing Research
|February 28, 2020
Summary
Asthma rates vary significantly by neighborhood, with Black boys experiencing the highest healthcare encounter rates. Social vulnerability, not green space or traffic, was linked to asthma healthcare visits.
Area of Science:
- Environmental health
- Public health
- Epidemiology
Background:
- Asthma affects approximately 12.5% of the US population, incurring substantial medical costs and contributing to school absenteeism.
- Environmental factors like green space access and air quality may disproportionately impact vulnerable populations.
- Understanding neighborhood-level environmental associations with asthma is crucial for targeted interventions.
Purpose of the Study:
- To investigate the relationship between neighborhood social, built, and natural environments and asthma-related healthcare encounters in Washington, DC.
- To identify specific environmental risk factors associated with higher asthma rates across different ZIP codes and subpopulations.
- To explore the utility of ZIP code-level analysis for environmental health research.
Main Methods:
- Utilized DC Health data from 2014-2017, linking asthma healthcare encounter rates to ZIP code-level environmental data.
- Included measures of social vulnerability, green space access, and traffic exposure.
- Analyzed variations in asthma rates by ZIP code and demographic subgroups, particularly focusing on Black boys.
Main Results:
- Significant ZIP code-level disparities in asthma-related healthcare encounters were observed.
- The Social Vulnerability Index at the ZIP code level showed a consistent association with asthma healthcare encounters.
- No significant association was found between asthma healthcare encounters and access to green space or high traffic exposure.
- Variability within ZIP codes suggests that this geographic level may be insufficient for analyzing built/natural environmental impacts.
Conclusions:
- Neighborhood social vulnerability is associated with asthma healthcare utilization, highlighting health inequities.
- ZIP code-level analysis has limitations for capturing the impact of localized environmental features on asthma.
- School nurses and other healthcare professionals can play a role in addressing neighborhood environmental risk factors for asthma.
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