Perceptions of neighborhood safety and asthma among children and adolescents in Los Angeles: a multilevel analysis.
BACKGROUND
Research examining the impact of neighborhoods on asthma has shown an increased interest in the role of the psychosocial environment. We examined the associations between various measures of neighborhood safety, individual and family characteristics, and asthma outcomes among children in Los Angeles.


METHODS
Multilevel logistic regression models were used to analyze data on 3,114 children across 65 neighborhoods from Wave 1 of the Los Angeles Family and Neighborhood Survey (2000 to 2002). Primary caregivers reported asthma outcome and all individual covariates; home environmental characteristics were observed by the interviewer.


RESULTS
In fully adjusted models, parents who reported their neighborhood fairly safe or somewhat dangerous had lower odds of reported lifetime asthma compared to those who reported their neighborhood completely safe (OR 0.71; 95% CI 0.52-0.96 and OR 0.60; 95% CI 0.42-0.88 respectively). Conversely, parents who reported they could not trust their neighbors to keep their children safe had a nearly 40% increase in lifetime asthma compared to those who reported they could trust their neighbors to keep their children safe (OR 1.39; 95% CI 1.07-1.81).


CONCLUSIONS
The study demonstrates a complex pattern between various measures of neighborhood safety and asthma and suggests that these relationships may operate differently in Los Angeles. As an increasing proportion of children are growing up in newer Western and Southwestern cities, which have different physical layouts and residential segregation patterns compared to Northeast and Midwestern cities, future studies should continue to examine neighborhood psychosocial stressors and asthma in diverse contexts.
Department of Population Health, North Shore-LIJ Health System, Great Neck, New York, United States of America.
Marlene
M
Camacho-Rivera
Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, United States of America.
Ichiro
I
Kawachi
Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, United States of America.
Gary G
GG
Bennett
Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, United States of America.
S V
SV
Subramanian
D000293:Adolescent; D001249:Asthma / Q000453:epidemiology*; D002648:Child; D005191:Family Characteristics; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D055361:Multilevel Analysis; D011584:Psychology; D012044:Regression Analysis; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012449:Safety / Q000706:statistics & numerical data*; D012938:Social Perception