社会环境与哮喘：与犯罪和“不让一个孩子掉队”计划的关联。
Social environment and asthma: associations with crime and No Child Left Behind programmes.
机构信息
Centre for Research on Inner City Health, St Michael’s Hospital, Toronto, Ontario, Canada.
出版信息
J Epidemiol Community Health. 2011 Oct;65(10):859-65. doi: 10.1136/jech.2009.102806. Epub 2010 Nov 11.
BACKGROUND
The relationship between asthma and socio-economic status remains unclear. The authors investigated how neighbourhood, school and community social environments were associated with incident asthma in Southern California schoolchildren.
METHODS
New-onset asthma was measured over 3 years of follow-up in the Children's Health Study cohort. Multilevel random-effects models assessed associations between social environments and asthma, adjusted for individual risk factors. At baseline, subjects resided in 274 census tracts (ie, neighbourhoods) and attended kindergarten or first grade in one of 45 schools distributed in 13 communities throughout Southern California. Neighbourhoods and communities were characterised by measures of deprivation, income inequality and racial segregation. Communities were further described by crime rates. Information on schools included whether a school received funding related to the Title 1 No Child Left Behind programme, which aims to reduce academic underachievement in disadvantaged populations.
RESULTS
Increased risk for asthma was observed in subjects attending schools receiving Title I funds compared with those from schools without funding (adjusted HR 1.71, 95% CI 1.14 to 2.58), and residing in communities with higher rates of larceny crime (adjusted HR 2.02, 95% CI 1.08 to 3.02 across the range of 1827 incidents per 100,000 population).
CONCLUSIONS
Risk for asthma was higher in areas of low socio-economic status, possibly due to unmeasured risk factors or chronic stress.
背景
哮喘与社会经济地位之间的关系仍不清楚。作者研究了南加州学童的邻里、学校和社区社会环境与哮喘发病之间的关系。
方法
在“儿童健康研究”队列的 3 年随访中测量新出现的哮喘。多水平随机效应模型评估了社会环境与哮喘之间的关联，调整了个体危险因素。在基线时，受试者居住在 274 个普查区（即邻里），并在南加州 13 个社区的 45 所学校中的一所上幼儿园或一年级。邻里和社区的特点是贫困程度、收入不平等和种族隔离程度的指标。社区还进一步描述了犯罪率。有关学校的信息包括学校是否获得了与《不让一个孩子掉队》（Title 1）计划相关的资金，该计划旨在减少弱势人群的学业成绩不佳。
结果
与没有资金的学校相比，获得 Title I 资金的学校的哮喘发病风险增加（调整后的 HR 1.71，95%CI 1.14 至 2.58），而居住在盗窃犯罪率较高的社区的哮喘发病风险也增加（在盗窃犯罪率为每 10 万人 1827 起的范围内，调整后的 HR 为 2.02，95%CI 为 1.08 至 3.02）。
结论
在社会经济地位较低的地区，哮喘的风险更高，这可能是由于未测量的危险因素或慢性压力所致。
Zotero 插件