Are perceptions of community safety associated with respiratory illness among a low-income, minority adult population?

Kristen N. Arthur,Susanne Montgomery,Rhonda Spencer-Hwang,Samuel Soret,David Shavlik,Synnøve F. Knutsen

doi:10.1186/s12889-018-5933-4

Kristen N. Arthur, Susanne Montgomery + Show 4 more

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https://doi.org/10.1186/s12889-018-5933-4

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Abstract

BackgroundGrowing evidence suggests social disadvantage magnifies the harmful health effects of environmental hazards; however, there is limited research related to perceptions of risk among individuals who live near such environmental hazard sites. We explored the association between individual-level perception of community safety and respiratory illness among low-income, minority adults who live in a region with routine poor air quality exacerbated by the emissions of a nearby freight railyard.MethodsInterview-administered household surveys were collected (87% response rate; n = 965) in English/Spanish from varying distances surrounding a freight railyard (analytic total n = 792: nearest region n = 215, middle n = 289, farthest n = 288). Illness outcome was an affirmative response to doctor-diagnosed asthma, bronchial condition, emphysema, COPD, or prescribed-inhaler usage. Respiratory symptoms outcome was an affirmative response to chronic cough, chronic mucus, or wheezing. The independent variable was perceived community safety.ResultsOutcome prevalences were similar across environmental hazard regions; 205 (25.9%) were diagnosed-illness cases and 166 (21.0%) diagnosis-free participants reported symptoms. Nearly half (47.5%) of participants reported lack of perceived community safety, which was associated with environmental hazard region (p < 0.0001). In multivariable log-binomial regression models adjusting for covariables (age, gender, race/ethnicity, smoking status, smoke exposure, residential duration, and distance from the railyard) respiratory illness diagnosis was associated with lack of perceived community safety (PR = 1.39; 95% CI 1.09, 1.76). Sensitivity analyses showed a non-significant but increasing trend in the strength of association between safety perceptions and illness diagnoses with closer proximity to the railyard.ConclusionsOur findings contribute to the literature that individuals’ perceptions of community safety are associated with adverse respiratory health among a population living in high air pollution exposure areas.

Highlights

Growing evidence suggests social disadvantage magnifies the harmful health effects of environmental hazards; there is limited research related to perceptions of risk among individuals who live near such environmental hazard sites
We studied the association between perceived lack of community safety stressors and the outcomes using multivariable log-binomial regression models which allowed for the calculation of prevalence ratios (PR) and 95% confidence intervals [41]
Perceived community safety Two-hundred twenty-five (28.4%) participants reported feeling unsafe walking in their community, 309 (39.0%) reported violence/crime to be a problem in their community, and 376 (47.5%) reported a lack of perceived community safety as measured by the construct variable

Summary

Introduction

Growing evidence suggests social disadvantage magnifies the harmful health effects of environmental hazards; there is limited research related to perceptions of risk among individuals who live near such environmental hazard sites. We explored the association between individual-level perception of community safety and respiratory illness among low-income, minority adults who live in a region with routine poor air quality exacerbated by the emissions of a nearby freight railyard. Animal studies support the biologic plausibility that chronic social stress leads to greater susceptibility of respiratory health issues due to air pollution exposure. Neighborhood-level violence/crime, as a measure for psychosocial stress, is a suggested risk factor in the pathophysiology of asthma incidence and morbidity [20, 21]. Exposure to violence, measured individually, has been consistently associated with worsening asthma morbidity in children [10, 24, 25], risk of asthma among children [11, 26], and asthma symptom severity in adults [27, 28]. The Adverse Childhood Experiences Study has found a graded and significant relationship between exposure to violence/trauma during childhood and incidence and morbidity of chronic obstructive pulmonary disease (COPD) as an adult [29]

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