Mapping inequality: Childhood asthma and environmental injustice, a case study of St. Louis, Missouri
Mapping inequality: Childhood asthma and environmental injustice, a case study of St. Louis, Missouri
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DOI：
10.1016/j.socscimed.2019.03.040
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发表时间：
2019-06-01
影响因子：
5.4
通讯作者：
Harris, Kelly M.
中科院分区：
文献类型：
--
作者：
Harris, Kelly M.
随着贫困和富裕的地理连续体的出现，健康状况良好和不良的地理连续体也随之出现。哮喘是目前最流行的慢性儿童疾病之一。在过去的三十年中，哮喘发病率增幅最大的是城市地区，并且对贫困青年以及少数种族和族裔群体的影响尤为严重。社区作为一种机制，助长了环境不公正，并使我们最弱势群体的健康结果和生活机会方面的差异永久化。本研究在密苏里州圣路易斯的案例研究中使用地理信息系统 (GIS) 方法，通过识别“热点”或儿童哮喘高或低水平的统计显着空间聚类，以及与邻里特征、社会人口特征以及这些热点内医疗资源获取情况的关联，来检查当地环境风险。结果显示，哮喘高发率在统计上显着集中在非白人和贫困居民较多、公共住房、住房恶化和暴力犯罪率较高的地区。哮喘高发区也位于医疗保健资源（例如医生和药物）有限且入学率较低的地区。这些哮喘高发地区的居民面临着更大的环境风险，并且在健康和教育成果、身体和财务医疗保健资源以及整体福祉方面存在显着差异。这项研究展示了这些基于地点的不平等，并提供了环境不公正的明确证据，支持了投资和干预措施的必要性，以改善我们最弱势青年的环境、健康和经济资源。
As a geographic continuum of poverty and affluence has emerged, so too has a geographic continuum of good and poor health. Asthma is currently one of the most prevalent chronic childhood diseases. Over the past three decades, the greatest increases in asthma rates have been in urban areas and have disproportionately affected youth in poverty and those in racial and ethnic minority groups. Neighborhoods serve as a mechanism fostering environmental injustice and perpetuating these disparities in health outcomes and life opportunity for our most vulnerable populations. Using Geographic Information Systems (GIS) methods in a case study of St. Louis Missouri, this study examines local environmental risk by identifying 'hotspots,' or statistically significant spatial clustering of high or low levels of childhood asthma, and associations with neighborhood characteristics, socio-demographic characteristics, and access to healthcare resources within these hotspots. Results revealed statistically significant clustering of high asthma rates in areas with more non-White and poor residents, higher rates of public housing, deteriorating housing, and violent crime. High asthma hotspots were also located in areas with limited physical access to healthcare resources, such as physicians and medication, and lower school attendance rates. Residents of these high asthma hotspots experience greater environmental risk, and significant disparities in health and education outcomes, physical and financial healthcare resources, and overall well-being. This study demonstrates these place-based inequalities and presents clear evidence of environmental injustice, supporting the need for investments and interventions to improve the environments, health, and economic resources of our most vulnerable youth.