Violent crime and socioeconomic deprivation in shaping asthma-related pollution susceptibility: a case-crossover design.
Violent crime and socioeconomic deprivation in shaping asthma-related pollution susceptibility: a case-crossover design.
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暴力犯罪和社会经济剥夺对哮喘相关污染易感性的影响：案例交叉设计。
DOI：
10.1136/jech-2018-211816
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发表时间：
2019
影响因子：
6.3
通讯作者：
Clougherty,JaneE
中科院分区：
文献类型：
--
作者：
Sheffield,PerryE;Shmool,JessieLC;Kinnee,EllenJ;Clougherty,JaneE
背景本研究的目的是量化和比较社区暴力犯罪和社会经济剥夺对改变臭氧与儿童哮喘急诊室 (ED) 就诊之间关系的相对影响。方法我们根据全州行政 ED 数据集，对 2005 年至 2011 年 5 月至 9 月期间所有纽约市 ED 进行时空病例交叉分析。数据包括 11 719 名 5-18 岁的哮喘儿童，主要结果指标是基于 Cox 回归分析的哮喘急诊就诊的超额风险百分比。 结果观察到，犯罪率上升和贫困程度增加与臭氧与哮喘之间的关联性更强（例如，在滞后第 2 天，我们发现 20.0%（95% CI 10.2% 至 30.6%）和 21.0% （对于暴力犯罪和贫困最高和最低四分位数的社区，每 10 ppb 臭氧的风险分别增加 10.5% 至 32.5%）。然而，在考虑这两种修饰因素的不同模型中，只有暴力保留了显着性。结论结果表明，在暴力犯罪或贫困程度较高的社区中，臭氧与哮喘的时空关联性更强。值得注意的是，暴力是更一致和更重要的修饰因素，可能调解很大一部分与社会经济地位相关的敏感性。
BackgroundThe objective of this study was to quantify and compare the relative influence of community violent crime and socioeconomic deprivation in modifying associations between ozone and emergency department (ED) visits for asthma among children.MethodsWe used a spatiotemporal case-crossover analysis for all New York City EDs for the months May–September from 2005 to 2011 from a statewide administrative ED dataset. The data included 11 719 asthmatic children aged 5–18 years, and the main outcome measure was percentage of excess risk of asthma ED visit based on Cox regression analysis.ResultsStronger ozone–asthma associations were observed for both elevated crime and deprivation (eg, on lag day 2, we found 20.0% (95% CI 10.2% to 30.6 %) and 21.0% (10.5% to 32.5%) increased risk per 10 ppb ozone, for communities in the highest vs lowest quartiles of violent crime and deprivation, respectively). However, in varied models accounting for both modifiers, only violence retained significance.ConclusionsThe results suggest stronger spatiotemporal ozone–asthma associations in communities of higher violent crime or deprivation. Notably, violence was the more consistent and significant modifier, potentially mediating a substantial portion of socioeconomic position–related susceptibility.