41 - Neighborhood Conditions, Asthma, and Household Environments with Allergens or Irritants in Teenagers

Poster Number: 41
Publication Number: 41.300

Kristen H. Shanahan, Boston Children's Hospital, Boston, MA, United States; Peter James, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States; Sheryl Rifas-Shiman, Harvard Medical School and HPHCI, Boston, MA, United States; Emily Oken, Harvard Pilgrim Health Care Institute, Boston, MA, United States; Izzuddin Aris, Harvard Medical School, Boston, MA, United States

Background: The child opportunity index (ChOI) is a publicly available surveillance tool that describes neighborhood conditions important for child health and development. Neighborhood conditions are associated with hospitalization and emergency care for asthma in children. Evidence on the pathways linking neighborhood opportunity with asthma morbidity is limited.

Objective: To examine associations of neighborhood opportunity with household environments with allergens or irritants, as well as asthma diagnosis and lung function among teens.

Design/Methods: We geocoded residential addresses in early adolescence in Project Viva, a prebirth cohort from eastern Massachusetts (mean age 13.2 years, 2013-2016). We linked addresses to census tract-level ChOI data, aggregated into overall and domain-specific scores. Our primary outcome was living in a household environment with allergens or irritants (mildew, water damage, cockroaches, rats, or mice), obtained from questionnaires. Secondary outcomes included (1) current asthma reported on the questionnaire and (2) pulmonary function test results (ratio of forced expiratory volume in one second to forced vital capacity, FEV1/FVC). All data were collected in early adolescence. We used mixed-effects linear and logistic regression models to evaluate cross-sectional associations of ChOI scores (overall and domain-specific) with outcomes, adjusting for individual and family sociodemographics and clustering by census tract.

Results: Among the 1091 participants, 9% resided in neighborhoods with very low overall opportunity and 56% resided in neighborhoods with very high overall opportunity (Table 1). Teens residing in areas with higher overall opportunity (per 25 unit increase in overall ChOI scores, range 0-100) had lower odds of living in a household environment with allergens or irritants in adjusted models (OR 0.83; 95% CI 0.70, 0.98, Table 2, Figure 1). In unadjusted models, children residing in areas with higher overall opportunity had lower odds of having a current asthma (OR 0.78; 95% CI 0.68, 0.90) and higher FEV1/FVC (β 0.41; 95% CI 0.01, 0.80, Table 2). These associations were attenuated in adjusted models (Table 2, Figure 1). Children residing in areas with higher scores in the social and economic domain had lower odds of living in a household environment with allergens or irritants in adjusted models (OR 0.85, 95% CI 0.72, 1.00, Table 2).Conclusion(s): In early adolescence, more favorable neighborhood environment was associated with lower likelihood of living in a household environment with water damage, mildew, and pests, but not with current asthma or lung function.
Kristen Shanahan - Curriculum Vitae 01/2022K Shanahan CV 1.5.2022.pdf
Table 2: Unadjusted and adjusted associations of neighborhood Child Opportunity Index scores (overall and domain-specific) with household environments with allergens or irritants, current asthma, and pulmonary function (FEV1/FVC) in early teen years.