Neighborhood Measures Research Articles

The Association Between Neighborhood Social Vulnerability and Cardiovascular Health Risk Among Black/African American Women in the InterGEN Study.

Black/African American women in the United States are more likely to live in neighborhoods with higher social vulnerability than other racial/ethnic groups, even when adjusting for personal income. Social vulnerability, defined as the degree to which the social conditions of a community affect its ability to prevent loss and suffering in the event of disaster, has been used in research as an objective measure of neighborhood social vulnerability. Black/African American women also have the highest rates of hypertension and obesity in the United States. The purpose of this study was to examine the relationship between neighborhood social vulnerability and cardiovascular risk (hypertension and obesity) among Black/African American women. We conducted a secondary analysis of data from the InterGEN Study that enrolled Black/African American women in the Northeast United States. Participants' addresses were geocoded to ascertain neighborhood vulnerability using the Centers for Disease Control and Prevention's Social Vulnerability Index at the census tract level. We used multivariable regression models to examine associations between objective measures of neighborhood quality and indicators of structural racism and systolic and diastolic blood pressure and obesity (body mass index > 24.9) and to test psychological stress, coping, and depression as potential moderators of these relationships. Seventy-four percent of participating Black/African American women lived in neighborhoods in the top quartile for social vulnerability nationally. Women living in the top 10% of most socially vulnerable neighborhoods in our sample had more than a threefold greater likelihood of hypertension when compared to those living in less vulnerable neighborhoods. Objective neighborhood measures of structural racism (percentage of poverty, percentage of unemployment, percentage of residents >25 years old without a high school diploma, and percentage of residents without access to a vehicle) were significantly associated with elevated diastolic blood pressure and obesity in adjusted models. Psychological stress had a significant moderating effect on the associations between neighborhood vulnerability and cardiovascular risk. We identified important associations between structural racism, the neighborhood environment, and cardiovascular health among Black/African American women. These findings add to a critical body of evidence documenting the role of structural racism in perpetuating health inequities and highlight the need for a multifaceted approach to policy, research, and interventions to address racial health inequities.

1109-P: The Effect of Neighborhood Food Environment on Diabetes Risk: A Multilevel Analysis of the Veterans Administration Diabetes Risk Cohort

Diabetes causes significant morbidity and mortality among adults in the US, yet incidence varies across the country, suggesting that neighborhood factors may contribute to geographic disparities in diabetes. In this longitudinal study, we examined the association between neighborhood food environment and risk of newly diagnosed (“incident”) diabetes in different communities (high density urban, low density urban, suburban, and rural). We created a retrospective dynamic, national cohort of 6,082,018 diabetes free US veterans identified from the Veterans Affairs electronic health records, enrolled between 2008 and 2016, and followed through 2018. Incident diabetes was defined as: 2 clinical encounters with diabetes ICD codes, a documented prescription for diabetes medication other than metformin or acarbose alone, or 1 clinical encounter with diabetes ICD codes and 2 elevated A1C (≥6.5%). Five-year average counts of fast-food restaurants and supermarkets relative to all other food outlets were used to generate two census tract-level neighborhood measures. We examined the association between food environment and incident diabetes using piecewise exponential survival models with county-level random effects. The average age of cohort participants was 59 years; the majority were non-Hispanic white (76.3%) and male (92.2%). Relative density of fast-food restaurants was associated with a modest increased risk of diabetes in all community types; adjusted hazard ratios (aHR) in high density urban, low density urban, and suburban communities were each 1.1, in rural communities was 1.2 (p < 0.05 for all). Relative density of supermarkets was associated with lower diabetes risk in suburban and rural communities only (aHR 0.7, 0.8, respectively, p <0.05). Neighborhood fast food and supermarkets influenced diabetes risk among US veterans in multiple community types, suggesting potential avenues for action to address the diabetes burden. Disclosure R. Kanchi: None. G. Imperatore: None. B. Elbel: None. L. Thorpe: None. P. M. Lopez: None. P. E. Rummo: None. D. C. Lee: None. S. Adhikari: Research Support; Self; Johnson & Johnson. M. D. Schwartz: None. S. Avramovic: None. K. R. Siegel: None. D. B. Rolka: None. Funding Centers for Disease Control and Prevention

A novel hybrid feature selection method considering feature interaction in neighborhood rough set

The interaction between features can provide essential information that affects the performances of learning models. Nevertheless, most feature selection methods do not take interaction into account in feature correlations calculation. In this work, to solve the problem of dimensional reduction in hybrid data with uncertainty and noise, a novel feature selection method is proposed considering the characteristic of interaction in the neighborhood rough set. First of all, the multi-neighborhood radii set for hybrid data is obtained according to the distribution characteristics of features. Then, considering the ubiquity of interactive features, the feature correlations are redefined via employing various neighborhood information uncertainty measures. Furthermore, a new objective evaluation function of the interactive selection of hybrid features is developed, which is called the Max-Relevance min-Redundancy Max-Interaction (MRmRMI). Finally, a novel interaction feature selection algorithm based on neighborhood conditional mutual information (NCMI_IFS) is designed. To evaluate the performance of the proposed algorithm, we compare it with other eight representative feature selection algorithms on twenty public datasets. Experimental results on four different classifiers show that the NCMI_IFS algorithm has higher classification performance and is significantly effective.

Life cycle gas path performance monitoring with control loop parameters uncertainty for aeroengine

This paper addresses the extended Kalman filtering approach to aircraft engine gas path analysis with control loop parameter uncertainty, which results from faulty sensors and actuators. A novel approach of gas path performance anomaly detection is proposed during the life course, which relies on combinations of recovered and actual measurements. A couple of adaptive onboard engine models (AOBEMs) are designed independently tuned to the real engine with state buffers, and sensor and actuator fault isolation (SAFI) logic is developed using hybrid matrices of the AOBEM couple. Neighborhood measurements with prior thermodynamic analysis reconstruct the faulty sensor signal once the control loop fault is recognized by the SAFI logic. The contribution of this paper is to develop engine performance monitoring against uncertain parameters over time in a control loop, and the gas path fault false alarm rate is independent of sensor and actuator faults. The tests involve abrupt fault and degradation datasets of the aircraft engine life cycle in the flight envelope, and the results demonstrate the superiority of the proposed methodology in the uncertain engine control loop.

Individual and neighbourhood socioeconomic measures and the risk of non-central nervous system solid tumours in children: A nationwide register-based case-control study in Denmark

BackgroundThe aetiology for most solid tumours in childhood is largely unknown. The lack of evidence concerns also the relationship between socioeconomic position (SEP) and risk of childhood solid tumours other than in the central nervous system (CNS). We sought to access the association between individual and neighbourhood SEP measures and risk of childhood non-CNS solid tumours in Denmark and to evaluate whether associations varied by measure of SEP, time point of SEP assessment (during pregnancy versus before diagnosis) and tumour type. MethodsWe conducted a nationwide case-control study based on Danish registry data. We identified all children born in 1980–2013 and diagnosed with a non-CNS solid tumour at ages 0–19 years (N = 1961) from the Danish Cancer Registry and sampled four individually matched controls per case using the Population Registry. We fitted conditional logistic regression models to estimate associations with register-based individual-level and neighbourhood-level SEP measures. ResultsWe observed a tendency of increased odd ratios (OR) in association with medium and high maternal income for most tumour types (e.g. OR for the highest income quintile and malignant bone tumours = 2.11; 95 % CI: 1.01, 4.38) and for parental education in association with higher education for some tumour types. For malignant epithelial neoplasms, higher parental education and income level were overall associated with an increased risk, e.g. OR = 1.63 (95 % CI: 1.00, 2.65) for the fourth group of maternal income during pregnancy. We found no risk pattern for neighbourhood SEP. ConclusionThis large register-study with minimal risk of bias found a tendency of slightly to moderately increased risks for most childhood non-CNS solid tumours in association with higher maternal income and parental education. Future research examining the underlying mechanisms of these socioeconomic differences in non-CNS solid tumours as well as other childhood cancer types are warranted.

Phonological neighborhood measures and multisyllabic word acquisition in children.

Multisyllabic words constitute a large portion of children's vocabulary. However, the relationship between phonological neighborhood density and English multisyllabic word learning is poorly understood. We examine this link in three, four and six year old children using a corpus-based approach. While we were able to replicate the well-accepted positive association between CVC word acquisition and neighborhood density, no similar relationship was found for multisyllabic words, despite testing multiple novel neighborhood measures. This finding raises the intriguing possibility that phonological organization of the mental lexicon may play a fundamentally different role in the acquisition of more complex words.

Neighborhood Disadvantage Measures and COVID-19 Cases in Boston, 2020.

Understanding the pattern of population risk for coronavirus disease 2019 (COVID-19) is critically important for health systems and policy makers. The objective of this study was to describe the association between neighborhood factors and number of COVID-19 cases. We hypothesized an association between disadvantaged neighborhoods and clusters of COVID-19 cases. We analyzed data on patients presenting to a large health care system in Boston during February 5-May 4, 2020. We used a bivariate local join-count procedure to determine colocation between census tracts with high rates of neighborhood demographic characteristics (eg, Hispanic race/ethnicity) and measures of disadvantage (eg, health insurance status) and COVID-19 cases. We used negative binomial models to assess independent associations between neighborhood factors and the incidence of COVID-19. A total of 9898 COVID-19 patients were in the cohort. The overall crude incidence in the study area was 32 cases per 10 000 population, and the adjusted incidence per census tract ranged from 2 to 405 per 10 000 population. We found significant colocation of several neighborhood factors and the top quintile of cases: percentage of population that was Hispanic, non-Hispanic Black, without health insurance, receiving Supplemental Nutrition Assistance Program benefits, and living in poverty. Factors associated with increased incidence of COVID-19 included percentage of population that is Hispanic (incidence rate ratio [IRR] = 1.25; 95% CI, 1.23-1.28) and percentage of households living in poverty (IRR = 1.25; 95% CI, 1.19-1.32). We found a significant association between neighborhoods with high rates of disadvantage and COVID-19. Policy makers need to consider these health inequities when responding to the pandemic and planning for subsequent health needs.

Characterization of heat index experienced by individuals residing in urban and rural settings.

Heatwave warning systems rely on forecasts made for fixed-point weather stations (WS), which do not reflect variation in temperature and humidity experienced by individuals moving through indoor and outdoor locations. We examined whether neighborhood measurement improved the prediction of individually experienced heat index in addition to nearest WS in an urban and rural location. Participants (residents of Birmingham, Alabama [N=89] and Wilcox County, Alabama [N=88]) wore thermometers clipped to their shoe for 7 days. Shielded thermometers/hygrometers were placed outdoors within participant’s neighborhoods (N=43). Nearest WS and neighborhood thermometers were matched to participant’s home address. Heat index (HI) was estimated from participant thermometer temperature and WS humidity per person-hour (HI[individual]), or WS temperature and humidity, or neighborhood temperature and humidity. We found that neighborhood HI improved the prediction of individually experienced HI in addition to WS HI in the rural location, and neighborhood heat index alone served as a better predictor in the urban location, after accounting for individual-level factors. Overall, a 1°C increase in HI[neighborhood] was associated with 0.20°C [95%CI (0.19, 0.21)] increase in HI[individual]. After adjusting for ambient condition differences, we found higher HI[individual] in the rural location, and increased HI[individual] during non-rest time (5am-midnight) and on weekdays.

Cross-Sectional Associations of Built and Social Neighborhood Environment Variables with Body Mass Index in a Large Sample of Urban Predominantly African American Children.

Background and Objectives: Neighborhood environments may play a role in the development of child obesity by providing or limiting opportunities for children to be physically active and access healthy food near the home. This study quantifies associations between the neighborhood built and social environment and age- and sex- standardized body mass index (BMI) z-scores in a predominantly African American urban sample. Methods: Electronic health record data from a pediatric integrated delivery system (N = 26,460 children, 6 to 19 years old in Philadelphia in 2014) were linked to eight built and social neighborhood environment characteristics. Generalized estimating equations were used to obtain adjusted associations between neighborhood features and age- and sex-adjusted BMI Z-score. Interactions between built and social exposures were examined, as well as effect modification by age, sex, neighborhood socioeconomic status, and population density. Results: Of 26,460 children, 17% were overweight and 21% were obese. After adjustment for individual- and neighborhood-level confounders, higher neighborhood greenness and higher walkability were associated with lower BMI z-score [mean difference per standard deviation (SD): -0.069 (95% confidence interval: [-0.108 to -0.031] and -0.051 [-0.085, -0.017], respectively)]. Higher levels of neighborhood food and physical activity resources were associated with higher BMI z-score [mean difference per SD 0.031 (0.012 and 0.050)]. We observed no interaction between the built and social neighborhood measures. Conclusion: Policies to promote walkability and greening of urban neighborhoods may contribute to preventing obesity in children.

Neighborhood Characteristics and the Mental Health of Caregivers Cohabiting with Care Recipients Diagnosed with Alzheimer's Disease.

While studies have documented the influence of caregiver and care recipient factors on caregiver health, it is important to address the potential impact of neighborhood contexts. This study estimated the cross-sectional associations between neighborhood characteristics and mental health among caregivers cohabiting with Alzheimer’s disease care recipients that were experiencing severe or non-severe neuropsychiatric symptoms (NPSs) (e.g., aggression/anxiety). We obtained data collected in 2010 on caregivers and care recipients (n = 212) from a subset of South Carolina’s Alzheimer’s Disease Registry. Neighborhood measures (within 1 mile of the residence) came from the American Community Survey and the Rural-Urban Commuting Area Code. We categorized the neighborhood median household income into tertiles, namely, “low” (<$31,000), “medium” ($31,000–40,758), and “high” (>$40,758), and rurality as “large urban,” “small urban,” and “rural.” We used negative binomial regression to estimate the prevalence ratios (PRs) and 95% confidence intervals (CIs) for caregiver mental health using neighborhood characteristics. The mean age was 58 ± 10.3 years, 85% were women, and 55% were non-Hispanic Black. Among the caregivers cohabiting with a recipient experiencing severe NPS, higher distress was experienced by caregivers living in low- (PR = 1.61 (95% CI = 1.26–2.04)) and medium- (PR = 1.45 (95% CI = 1.17–1.78)) vs. high-income neighborhoods after an adjustment. These results suggest that neighborhood characteristics may amplify other social stressors experienced by caregivers.

Investigating associations between physical activity-related neighborhood built environment features and child weight status to inform local practice.

Despite evidence of the importance of neighborhood built environment features in relation to physical activity and obesity, research has been limited in informing localized practice due to small sample sizes and limited geographic coverage. This demonstration study integrated data from a local pediatric health system with nationally available neighborhood built environment data to inform local decision making around neighborhood environments and childhood obesity. Height/weight from clinic visits and home neighborhood measures from the U.S. Environmental Protections Agency and WalkScore were obtained for 15,989 6-17 year olds. Multilevel models accounted for the nested data structure and were adjusted for neighborhood income and child sociodemographics. In 9-17 year olds, greater street connectivity and walkability were associated with a 0.01-0.04 lower BMIz (Ps=.009-.017) and greater residential density, street connectivity, and walkability were associated 5-7% lower odds of being overweight/obese (Ps=.004-.044) per standard deviation increase in environment variable. 45.9% of children in the lowest walkability tertile were overweight or obese, whereas 43.1% of children in the highest walkability tertile were overweight or obese. Maps revealed areas with low walkability and a high income-adjusted percent of children overweight/obese. In the Kansas City area, data showed that fewer children were overweight/obese in more walkable neighborhoods. Integrating electronic health records with neighborhood environment data is a replicable process that can inform local practice by highlighting the importance of neighborhood environment features locally and pointing to areas most in need of interventions.

Lexical activation in late bilinguals: effects of phonological neighbourhood on spoken word production

ABSTRACT This research explores patterns of lexical activation of both languages of a bilingual when producing spoken words. Specifically, it investigates the influence of within- and cross-language measures of phonological neighbourhood, on the English picture naming performance of a diverse group of French (L1) – English (L2) late bilinguals. A novel phonological neighbourhood density measure was used that took into account the phonological and lexical constraints of this sample of late bilinguals. Results showed that both within- and cross-language neighbours influenced picture naming performance and that the length of exposure to L2 and familiarity of the target modulated these effects, with both facilitatory and inhibitory effects observed. Additionally, the previously well-attested cognate facilitation effect decreased with L2 language exposure. These results support interactive models of word production, within a language non-specific view of lexical access, and show the dynamic nature of a bilingual’s lexical connections.

Perception Versus Reality: Subjective and Objective Neighborhood Characteristics and Cognitive Function in REGARDS

Does the world shrink as we age? The neighborhood captures a spatial area someone inhabits and moves through on a daily basis. It reflects a balance between internal perceptions and abilities, and the external environment which may enable or restrict participation in everyday life. We frequently hear that older adults have shrinking neighborhoods given declining functional mobility. This is associated with declines in physical and cognitive functioning, depression, poorer quality of life, and mortality. Knowledge of the interplay between objective and subjective neighborhood measurement remains limited. This symposium will explore these linked yet distinct constructs based on secondary data analyses of the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a racially diverse sample of 30,000+ aging Americans. Finlay investigates how someone’s perceived neighborhood size (in number of blocks) varies by individual and geographic characteristics including age, cognitive function, self-rated health, and urban/rural context. Esposito’s analyses focus on neighborhood size in relation to race and residential segregation. Clarke compares subjective perceptions of neighborhood parks and safety from crime to objective indicators, and examines variations by health and cognitive status. Barnes will critically consider implications for how older adults interpret and engage with their surrounding environments. The symposium questions the validity of neighborhood-based metrics to reflect the perspectives and experiences of older residents, particularly those navigating cognitive decline. It informs policy-making efforts to improve physical neighborhood environments and social community contexts, which are critical to the health and well-being of older adults aging in place.

Activity Locations, Residential Segregation, and the Significance of Residential Neighborhood Boundary Perceptions.

The inadequacies of residential census geography in capturing urban residents' routine exposures have motivated efforts to more directly measure residents' activity spaces. In turn, insights regarding urban activity patterns have been used to motivate alternative residential neighborhood measurement strategies incorporating dimensions of activity space in the form of egocentric neighborhoods-measurement approaches that place individuals at the center of their own residential neighborhood units. Unexamined, however, is the extent to which the boundaries of residents' own self-defined residential neighborhoods compare with census-based and egocentric neighborhood measurement approaches in aligning with residents' routine activity locations. We first assess this question, examining whether the boundaries of residents' self-defined residential neighborhoods are in closer proximity to the coordinates of a range of activity location types than are the boundaries of their census and egocentric residential neighborhood measurement approaches. We find little evidence that egocentric or, crucially, self-defined residential neighborhoods better align with activity locations, suggesting a division in residents' activity locations and conceptions of their residential neighborhoods. We then examine opposing hypotheses about how self-defined residential neighborhoods and census tracts compare in socioeconomic and racial composition. Overall, our findings suggest that residents bound less segregated neighborhoods than those produced by census geography, but self-defined residential neighborhoods still reflect a preference toward homophily when considering areas beyond the immediate environment of their residence. These findings underscore the significance of individuals' conceptions of residential neighborhoods to understanding and measuring urban social processes such as residential segregation and social disorganization.

High-dimensional brain-wide functional connectivity mapping in magnetoencephalography

BackgroundBrain functional connectivity (FC) analyses based on magneto/electroencephalography (M/EEG) signals have yet to exploit the intrinsic high-dimensional information. Typically, these analyses are constrained to regions of interest to avoid the curse of dimensionality, with the latter leading to conservative hypothesis testing. New methodWe removed such constraint by estimating high-dimensional source-based M/EEG-FC using cluster-permutation statistic (CPS) and demonstrated the feasibility of this approach by identifying resting-state changes in mild cognitive impairment (MCI), a prodromal stage of Alzheimer’s disease. Particularly, we proposed a unified framework for CPS analysis together with a novel neighbourhood measure to estimate more compact and neurophysiological plausible neural communication. As clusters could more confidently reveal interregional communication, we proposed and tested a cluster-strength index to demonstrate other advantages of CPS analysis. ResultsWe found clusters of increased communication or hypersynchronization in MCI compared to healthy controls in delta (1−4 Hz) and higher-theta (6−8 Hz) bands oscillations. These mainly consisted of interactions between occipitofrontal and occipitotemporal regions in the left hemisphere, which may be critically affected in the early stages of Alzheimer’s disease. ConclusionsOur approach could be important to create high-resolution FC maps from neuroimaging studies in general, allowing the multimodal analysis of neural communication across multiple spatial scales. Particularly, FC clusters more robustly represent the interregional communication by identifying dense bundles of connections that are less sensitive to inter-individual anatomical and functional variability. Overall, this approach could help to better understand neural information processing in healthy and disease conditions as needed for developing biomarker research.

Characterization of Heat Index Experienced by Individuals Residing in Urban and Rural settings

Background Heatwave warning systems rely on measurements taken at weather stations (WS), which do not reflect variation in temperature and humidity experienced by individuals moving through indoor and outdoor locations. We examined whether neighborhood measurement improved the prediction of individually experienced heat index in an urban vs. rural location.Methods Participants (residents of Birmingham, AL [N=89] and Wilcox County, AL [N=88]) wore thermometers clipped to their shoe for 7 days. Shielded thermometers/hygrometers were placed outdoors within participant’s neighborhoods (N=43). Nearest WS and neighborhood thermometers were matched to the participant's home address. Heat index (HI) was estimated from participant thermometer temperature and WS humidity per person-hour (HI[individual]), WS temperature and humidity (HI[WS]), or neighborhood temperature and humidity (HI[neighborhood]). Linear mixed models were fitted to determine the predictive value of WS and neighborhood HI for estimating HI[individual] in the urban and rural location.Results For all participants, a model with HI[neighborhood] alone explained the most variance in HI[individual]. A 1°C increase in HI[neighborhood] was associated with a 0.20°C [95%CI (0.19, 0.21) increase in HI[individual] in models adjusting for individual-level demographic factors. After adjusting for ambient condition differences, we found HI[individual] was heightened in the rural location compared to the urban location, particularly during non-rest hours (5am-midnight), when wind speed is higher, and on weekends. Both WS and neighborhood measurements underestimated the amount of time the participants experienced HI in the National Weather Service (NWS) Extreme Danger risk category compared to HI[individual]. Neighborhood measurements were better estimates of time spent in Danger and Extreme Danger NWS risk categories compared to WS.Conclusions Neighborhood measurements improved the prediction of individually-experienced HI, suggesting microclimates within neighborhoods are an important contributor to HI experienced by individuals.

Built environment correlates of objectively-measured sedentary behaviours in densely-populated areas.

Few studies examine associations between objectively-calculated neighbourhood built environment attributes and objectively-assessed sedentary behaviour in different geographical locations, especially in highly-populated environments. Additionally, no study, to our knowledge, has investigated associations between objective measures of neighbourhood built environment attributes and objectively-assessed sedentary behaviours in middle-aged adults, despite the fact that this is a critical stage of life when age-related functional decline begins. We examined the associations between neighbourhood built environment attributes with the total, and patterns of, objectively-assessed sedentary behaviours in a densely-populated area in Asia. Data from 866 adults (ages 40 to 64) living in Japan were included. Four classifications of sedentary behaviours, including daily total sedentary time, duration and number of long (≥30min) sedentary bouts and breaks per sedentary hour, were estimated using hip-worn accelerometers. Individual (population density, availability of destinations, number of intersections, and distance to the nearest park) and composite (walkability and Walk Score®) neighbourhood built environment indices were calculated using geographic information systems. Covariate-adjusted multilevel linear mixed effects models were used to estimate the associations between the neighbourhood built environment attributes and sedentary behaviours. Population density and availability of destinations were positively associated with sedentary behaviours; however, the number of intersections was negatively associated with sedentary behaviours. No associations were observed between the distance to the nearest park and sedentary behaviours. There were positive associations between walkability and total sedentary time, and duration and the number of long sedentary bouts. Walk Score® was positively associated with total sedentary time and the number of long sedentary bouts. These findings suggest that urban design attributes supportive of walking (except for the number of intersections) may encourage sedentary behaviour among middle-aged adults living in densely-populated environments.

Syllable and letter similarity effects in Korean: Insights from the Korean Lexicon Project

• Network analysis was used to quantify syllable and letter similarity of Korean words. • Visual lexical decision data for thousands of Korean words were analyzed. • Words in central locations of the syllable similarity space were recognized faster. • Greater letter similarity inhibited word recognition. • Korean readers process syllable and letter information in Hangul in complex ways. The Korean writing system, Hangul, is an alphabetic syllabary which permits a unique opportunity to investigate how both the syllabic and letter similarity structure of the Korean mental lexicon influences lexical processing. We capitalized on the availability of lexical decision behavioral data for thousands of Korean words, and the tools of network science to quantify the similarity structure of Korean words, to investigate the relative and interacting influences of syllable and letter similarity effects on Korean word recognition. Syllable and letter similarity measures were computed at both local and global levels of the lexicon, by considering the immediate neighbors of the target word (i.e., local) and the centrality of the target word with respect to the entire lexicon (i.e., global). Regression analyses showed that both local and global syllable and letter similarity influenced lexical decision performance, revealing a complex pattern of similarity effects where greater local similarity inhibited word recognition, and greater global distinctiveness facilitated word recognition. Furthermore, there were significant interaction effects between syllable and letter levels, suggesting that both syllabic and letter information are processed in an interactive fashion by Korean readers. Our findings demonstrate the importance of adopting computational methods that go beyond standard neighborhood measures and that can quantify the similarity relationships between words at multiple levels.

Early years pathways to inequalities in childhood asthma? A causal mediation analysis

Abstract Background Asthma affects one in five children in the United Kingdom (UK). Children in deprived areas have twice as many unplanned admissions for wheeze but mediating pathways between socioeconomic circumstances and asthma remain unclear. We aimed to quantify which early years pathways explain inequalities in childhood asthma in the UK. Methods We analysed data on 10650 children from the Millennium Cohort Study (MCS), a nationally representative sample of the UK population. Early life socioeconomic circumstance (SEC) was measured by maternal education at birth. Our outcome was parent-reported asthma at 5 years of age categorised as none, diagnosed asthma and diagnosed asthma with wheeze symptoms in the preceding year. Mediators were grouped into perinatal characteristics (maternal BMI, breastfeeding duration, birthweight, gestation, maternal smoking and alcohol use during pregnancy), neighbourhood features (pollution, grime and environment issues, traffic volume, housing quality) and the home environment (damp/condensation, tenure, pets, tobacco smoke). We used multinomial regression to examine the total effect of SEC on childhood asthma, then adjusted for all potential mediators. Using causal mediation analysis, we will estimate the proportion mediated by blocks of mediators and the natural indirect effect (NIE) via each block of mediators. Results Children whose mothers had no qualifications were more than twice as likely to have asthma by the age of 5 years with a wheeze episode in the preceding year compared with those whose mothers had degree-level qualifications (relative risk (RR) 2.21, 95% CI 1.44 to 3.40). After adjustment for all mediators, there was a 69% reduction to aRR 1.38 (95% CI 0.89 to 2.14). Conclusions Perinatal characteristics and early years neighbourhood features and measures of the home environment partially contribute to inequalities in childhood asthma. Key messages The antenatal period and early years of development are important for targeting interventions to reduce inequalities in asthma. About two-thirds of the social inequality in childhood asthma was explained by perinatal characteristics, early years neighbourhood features and the home environment.

Understanding the Link between Neighborhoods and Kidney Disease.

Neighborhoods are where we live, learn, work, pray, and play. Growing evidence indicates that neighborhoods are an important determinant of health. The built features of our neighborhoods, such as the ways in which the streets are designed and connected and the availability of green spaces and transit stops, as well as the social features, such as the trust among neighbors and the perceptions of safety, may influence health through multiple pathways, such as access to important resources, psychosocial stress, and health behaviors. In particular, the extant literature consistently documents an association between neighborhood features and renal-associated conditions, such as cardiovascular disease, hypertension, diabetes, and obesity. There is also some evidence suggesting an association between neighborhood poverty and ESKD. The link between neighborhood and earlier stages of CKD, however, has been less clear, with most studies documenting no association. It may be that the neighborhood measures used in previous studies do not capture features of the neighborhood important for earlier stages of disease development and progression. It may also be that our current biomarkers (e.g., eGFR) and urine protein are not able to pick up very early forms of renal damage because of the kidney's overall high reserve capacity. This paper critically reviews the state of the literature on neighborhood and renal disease, with recommendations for neighborhood measures in future research. Neighborhoods are designed, built, and informed by policy, and thus, they are amenable to intervention, making them a potentially powerful way to improve renal health and reduce health inequalities at the population level.