Neighborhood-level risk and resilience factors: an emerging issue in childhood asthma epidemiology.
Evaluation of: Gupta RS, Zhang X, Sharp LK, Shannon JJ, Weiss KB. The protective effect of community factors on childhood asthma. J. Allergy Clin. Immunol. 123(6), 1297-1304.e2 (2009). The recent increase in the prevalence of asthma in children is now recognized as the result of a complex interplay of genetic, sociodemographic and environmental factors. Multilevel models simultaneously account for neighborhood characteristics that may be related to childhood asthma, independently of individual-level attributes. Most research that focuses on the physical and social characteristics of neighborhoods to explain disparities in childhood asthma assess such factors as persistent poverty, residential racial segregation and environmental degradation. Researchers have only begun to test models that specifically focus on risk and protective factors at the community/neighborhood level in relation to asthma. Social capital, which measures norms of reciprocity, social ties between neighborhood residents and civic engagement has the potential to buffer the effects of neighborhood risk factors on childhood asthma. Further research, specifically longitudinal studies, needs to be carried out to determine whether findings on neighborhood-level risk and protective factors can guide the development of preventive interventions for childhood asthma.
Pearlman
Deborah N
DN
Brown University, Program in Public Health, 121 South Main Street, Box G-S121 (2nd Floor), Providence, RI 02912, USA. deborah_pearlman@brown.edu