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儿童时期向下流动的邻里贫困与儿童哮喘有关:来自幸福感地理研究(GROW)调查的证据。

Downward Neighborhood Poverty Mobility during Childhood Is Associated with Child Asthma: Evidence from the Geographic Research on Wellbeing (GROW) Survey.

机构信息

Population Research Center, The University of Texas at Austin, 1925 San Jacinto Boulevard, Austin, TX, 78712, USA.

Department of Sociology, The University of Texas at Austin, Austin, TX, USA.

出版信息

J Urban Health. 2019 Aug;96(4):558-569. doi: 10.1007/s11524-019-00356-2.

Abstract

Causal evidence regarding neighborhood effects on health remains tenuous. Given that children have little agency in deciding where they live and spend proportionally more of their lives in neighborhoods than adults, their exposure to neighborhood conditions could make their health particularly sensitive to neighborhood effects. In this paper, we examine the relationship between exposure to poor neighborhoods from birth to ages 4-10 and childhood asthma. We used data from the 2003-2007 California Maternal Infant and Health Assessment (MIHA) and the 2012-2013 Geographic Research on Wellbeing (GROW) survey (N = 2619 mother/child dyads) to fit relative risks of asthma for children who experience different types of neighborhood poverty mobility using Poisson regression controlling for individual-level demographic and socioeconomic characteristics, and neighborhood satisfaction. Our results demonstrate that [1] living in a poor neighborhood at baseline and follow-up and [2] moving into a poor neighborhood were each associated with higher risk of asthma, compared with children not living in a poor neighborhood at either time. Exposure to impoverished neighborhoods and downward neighborhood poverty mobility matters for children's health, particularly for asthma. Public health practitioners and policymakers need to address downward neighborhood economic mobility, in addition to downward family economic mobility, in order to improve children's health.

摘要

关于邻里效应对健康的因果证据仍然很薄弱。鉴于儿童在决定居住地点方面几乎没有自主权,并且在邻里环境中度过的时间比例比成年人高,因此他们接触邻里条件可能使他们的健康特别容易受到邻里效应的影响。在本文中,我们研究了从出生到 4-10 岁期间暴露于贫困社区与儿童哮喘之间的关系。我们使用了来自 2003-2007 年加利福尼亚母婴健康评估(MIHA)和 2012-2013 年幸福感地理研究(GROW)调查的数据(N=2619 对母婴对子),使用泊松回归控制个体水平的人口统计学和社会经济特征以及邻里满意度,来拟合经历不同类型邻里贫困流动的儿童哮喘的相对风险。我们的结果表明,[1] 与基线和随访时都没有居住在贫困社区的儿童相比,居住在贫困社区的儿童和[2] 搬入贫困社区的儿童患哮喘的风险更高。暴露于贫困社区和向下的邻里贫困流动对儿童的健康很重要,尤其是对哮喘。公共卫生从业人员和政策制定者需要解决向下的邻里经济流动性问题,除了向下的家庭经济流动性问题,以改善儿童的健康。

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