The Association Between Neighbourhood Stressors and Asthma Prevalence of School Children in Winnipeg

It is generally surmised that neighbourhood stressors have an incubating effect for a variety of diagnoses on maternal and child health. What is of interest is to determine if the frequency of asthma prevalence is greater amongst children resident of chronic stress neighbourhoods, after adjusting for family history of asthma and socioeconomic status (SES). The City of Winnipeg, Canada is used as a study location with the urban component of children (1472 entire; 698 birth home) extracted from the Study of Asthma, Genes and the Environment (SAGE) Survey administered in 2002-2003 to a birth cohort from 1995 in Manitoba. Dichotomous parent report of child asthma from the SAGE Survey nested within birth cohort are geocoded by postal code, which allows designation of neighbourhood. Hierarchical linear modelling (HLM) allows the individual effect of environmental exposures such as home smokers and pets to be isolated from the proportion of variance explained by stressor exposure grouped at the neighbourhood level in dependent outcome. Principal component and factor analysis are explored to reduce the dimensionality of collinear SES variables, and analysis of sensitivity and specificity was performed to validate parent report of child asthma to pediatric-allergist diagnosis for a subgroup of children. Flunctuation of childhood asthma between neighbourhoods is shown by geographical information systems (GIS), with the effect of neighbourhood in multilevel models observed to explain small to intermediate proportions of variance in parent report of child asthma. Children living in census tracts assigned low SES scores by compositional stressors obtained from the 1996 Canada Census were found to have a decreased odds of parent report of asthma, while those inhabiting profiles with high contextual crime rates from the 2001 Winnipeg Police Service Crime Data were at increased risk. Respondents who experienced relocation to low SES neighbourhoods were shown to have a higher odds of asthma than children resident of same neighbourhoods in birth home.;Keywords: Childhood Asthma, SAGE Survey, Hierarchical Linear Modelling, Spatial Statistics...