Are perceptions of community safety associated with respiratory illness among a low-income, minority adult population?
Are perceptions of community safety associated with respiratory illness among a low-income, minority adult population?
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DOI：
10.1186/s12889-018-5933-4
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发表时间：
2018-09-03
影响因子：
4.5
通讯作者：
Montgomery, Susanne
中科院分区：
文献类型：
--
作者：
Arthur, Kristen N.;Spencer-Hwang, Rhonda;Montgomery, Susanne
背景资料：越来越多的证据表明，社会劣势放大了环境危害对健康的有害影响;然而，与居住在这些环境危害地点附近的个人对风险的看法有关的研究有限。我们探讨了低收入、少数民族成年人对社区安全的个人感知与呼吸系统疾病之间的关系，这些成年人居住在一个空气质量普遍较差的地区，附近货运铁路站的排放加剧了空气质量的恶化。（87%的答复率; n = 965）从货运铁路站场周围不同距离的英语/西班牙语（分析总数n = 792：最近区域n = 215，中间区域n = 289，最远区域n = 288）。疾病结局是对医生诊断的哮喘、支气管疾病、肺气肿、COPD或处方吸入器使用的肯定反应。呼吸系统症状结局为对慢性咳嗽、慢性粘液或喘息的肯定应答。自变量是感知社区safety.Results：结果患病率是相似的环境危害区域，205（25.9%）被诊断为疾病的情况下，166（21.0%）诊断免费参与者报告症状。近一半（47.5%）的参与者报告缺乏社区安全感，这与环境危害区域有关（p < 0.0001）。在调整协变量（年龄、性别、种族/民族、吸烟状况、吸烟暴露、居住时间和距铁路站场的距离）的多变量对数二项回归模型中，呼吸系统疾病诊断与缺乏社区安全感相关（PR = 139; 95%CI 1.09，1.76）。敏感性分析表明，一个不显着的，但增加的趋势之间的关联强度的安全观念和疾病诊断与更接近的railyard.Conclusions：我们的研究结果有助于文献中，个人的社区安全的看法与不良呼吸系统健康的人口生活在高空气污染暴露地区。
Background: Growing 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.Methods: Interview-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.Results: Outcome 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 = 139; 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.Conclusions: Our 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.