2014 Progress Report: Community Stressors and Susceptibility to Air Pollution in Urban Asthma

EPA Grant Number: R834576
Title: Community Stressors and Susceptibility to Air Pollution in Urban Asthma
Investigators: Clougherty, Jane E. , Spengler, John D. , Kubzansky, Laura D. , Carr Shmool, Jessie L , Dotson-Newman, Ogonnaya , Shepard, Peggy
Current Investigators: Clougherty, Jane E. , Spengler, John D. , Kubzansky, Laura D. , Carr Shmool, Jessie L , Onokpise, Oghenekome U. , Ito, Kazuhiko , Shepard, Peggy
Institution: University of Pittsburgh , West Harlem Environmental Action (WE ACT for Environmental Justice) , Harvard University
Current Institution: University of Pittsburgh , Harvard University , New York University School of Medicine , West Harlem Environmental Action (WE ACT for Environmental Justice)
EPA Project Officer: Hahn, Intaek
Project Period: March 1, 2011 through February 28, 2015 (Extended to February 28, 2016)
Project Period Covered by this Report: March 1, 2014 through February 28,2015
Project Amount: $1,250,000
RFA: Understanding the Role of Nonchemical Stressors and Developing Analytic Methods for Cumulative Risk Assessments (2009) RFA Text |  Recipients Lists
Research Category: Human Health

Objective:

This project aims to understand relative spatial distributions in key community-level psychosocial stressors and air pollution exposures across New York City (NYC), and to examine their separate and synergistic effects of childhood asthma exacerbation.

Progress Summary:

Using publicly available indicators of community social stressors (e.g., poverty, violent crime) (Table 1), we have applied GIS-based methods to identify three spatially distinct suites of stressors in NYC. The factors do not all correlate strongly with socioeconomic position (SEP) in NYC, thus indicating that using poverty as a proxy for social stressor exposures may be misleading (Shmool, et al., 2014) and may confound spatially and conceptually distinct exposures.

Table 1. Summary Table of Community Stressor Data Collected and Analyzed Under Aim 2.

Stressor Construct

Indicator and Administrative Scale

Data Source and Date

Crime and Violence

Major felony crimes per 10,000 (PP)

Murder and non-negligent manslaughter per 10,000 (PP)

Felonious assault per 10,000 (PP)

Robbery per 10,000 (PP)

Burglary per 10,000 (PP)

% Perceptions of neighborhood safety (self-report) (UHF)

NYPD (FY 2009)

NYPD (FY 2009)

NYPD (FY 2009)

NYPD (FY 2009)

NYPD (FY 2009)

DOHMH CHS (2010)

Mental and General Health Status

% Depression diagnosis ever (self-report) (UHF)

% Mental health treatment in past year (self-report) (UHF)

% Fair or poor general health (self-report) (UHF)

DOHMH CHS (2009)

DOHMH CHS (2009)

DOHMH CHS (2009)

Physical/Built Environment

% Small parks not acceptably clean (CD)

% Sidewalks not acceptably clean (CD)

Serious housing violations per 1,000 rental units (CD)

Air quality complaints per 10,000 residents (CD)

% Crowding (>1 occupant/room) (USC Block Group)

NYC Parks (FY 2009)

MOO (FY 2009)

HPD (2009)

DEP (FY2009)

U.S. Census ACS (2005–09)

Access to Healthcare

% With no type of insurance coverage (self-report) (UHF)

% Went without needed medical care (self-report) (UHF)

% Without a personal care provider (self-report) (UHF)

Public health insurance enrollment per 10,000 (CD)

DOHMH CHS (2009)

DOHMH CHS (2009)

DOHMH CHS (2009)

MOO (FY 2009)

Noise Disruption

% Frequent noise disruption (3+ times/wk. over 3 months)

(self-report) (UHF)

% Noise disruption, by noise sources (i.e. neighbors, traffic)

(self-report) (UHF)

DOHMH CHS (2009)

DOHMH CHS (2009)

Childhood-Specific Stressors

% Students in schools exceeding capacity (SD)

% School buildings in good to fair condition (SD)

% Average daily student attendance (SD)

Substantiated cases of child abuse/neglect per 10,000 (CD)

NYC DOE (SY 2006–07)

NYC DOE (SY 2006–07)

NYC DOE (SY 2008–09)

NYC ACS (2008)

Socioeconomic Position

% Living below 200% federal poverty line (USC Block Group)

% Delayed rent or mortgage payment in past year (self-report) (UHF)

Food Stamp program enrollment per 10,000 (CD)

% Less than high school education (self-report) (UHF)

% Unemployed for less than 1 year (USC Tract)

U.S. Census ACS (2005–09)

DOHMH CHS (2009)

MOO (FY 2009)

DOHMH CHS (2009)

U.S. Census ACS (2005–09)

To better understand and validate these statistical analyses, we implemented two methods for assessing perceptions of stressors: (1) community focus groups, and (2) a spatially stratified citywide survey of NYC resident adults. We conducted 14 focus groups across NYC’s five boroughs to identify key community social and physical stressors, as well as positive aspects of communities. Using insights from these focus groups, we developed and implemented a systematic citywide survey for adult NYC residents (n = 1549, Figure 1), to capture individual-level perceived stress, mental health, and asthma outcomes data. In Year 3, we used survey data to identify those community-level social stressor indicators that best predict perceived social and physical neighborhood disorder, after adjusting for individual-level confounders (e.g., age, residential tenure); we found that area-level indicators of violent crime (e.g., felony assault), SEP (e.g., low education, unemployment) and built environment (e.g., sidewalk cleanliness, rental unit housing violations) were associated with perceived disorder, but other administrative data (including property-related crime, residential crowding and park quality) were not. In Year 4, we evaluated associations between validated stressor indicators and individual psychological distress (e.g., depression, perceived stress) and physical health (e.g., asthma, general health), with consideration of potential mediating and moderating pathways (i.e., social capital, interpersonal support). Currently, we are using case-crossover design to assess stress-related susceptibility to air pollution exposure in an epidemiologic investigation of childhood asthma hospitalizations. In Year 4, we developed high-accuracy geocoding methods to minimize exposure misclassification in our case-only cohort of asthma hospitalizations (2005–2011).


Figure 1. ZIP code–level spatial distribution of survey sample, by season.

In Year 4, WE ACT organized two New York City Community Air Network (NYCCAN) meetings to present research findings to diverse stakeholders, including community-based organizations, environmental health advocates, academic researchers and government agencies. In anticipation of grant closure, WE ACT engaged NYCCAN members in planning future advocacy and research issues to sustain and expand stakeholder engagement in air pollution, susceptibility, and health.

Future Activities:

Together, these data will enable us to systematically examine the association between validated community-level stressor indices (e.g., poverty or crime rates) and individual stress experience. In the no-cost extension year, we will refine multilevel and case-crossover epidemiological models of social stressor and air pollution exposure on child asthma hospitalizations (2005–2012) across NYC.


Journal Articles on this Report : 3 Displayed | Download in RIS Format

Other project views: All 53 publications 7 publications in selected types All 7 journal articles
Type Citation Project Document Sources
Journal Article Clougherty JE, Shmool JLC, Kubzansky LD. The role of non-chemical stressors in mediating socioeconomic susceptibility to environmental chemicals. Current Environmental Health Reports 2014;1(4):302-313. R834576 (2013)
R834576 (2014)
R834576 (Final)
  • Full-text: Springer-Full Text HTML
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  • Other: Spring-Full Text PDF
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  • Journal Article Shmool JLC, Kubzansky LD, Newman OD, Spengler J, Shepard P, Clougherty JE. Social stressors and air pollution across New York City communities: a spatial approach for assessing correlations among multiple exposures. Environmental Health 2014;13:91. R834576 (2012)
    R834576 (2013)
    R834576 (2014)
    R834576 (Final)
  • Full-text from PubMed
  • Abstract from PubMed
  • Associated PubMed link
  • Full-text: BioMed Central-Full Text HTML
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  • Abstract: BioMed Central-Abstract
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  • Other: BioMed Central-PDF
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  • Journal Article Shmool JL, Yonas MA, Newman OD, Kubzansky LD, Joseph E, Parks A, Callaway C, Chubb LG, Shepard P, Clougherty JE. Identifying perceived neighborhood stressors across diverse communities in New York City. American Journal of Community Psychology 2015;56(1-2):144-155. R834576 (2012)
    R834576 (2013)
    R834576 (2014)
    R834576 (Final)
  • Abstract from PubMed
  • Abstract: Wiley-Abstract
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  • Supplemental Keywords:

    case-crossover, childhood asthma exacerbation, community stressors, differential susceptibility, GIS, nonchemical stressors, psychosocial stress, spatial epidemiology, synergistic effects, traffic-related air pollution;

    Relevant Websites:

    Jane E. Clougherty | Environmental and Occupational Health | University of Pittsburgh Graduate School of Public Health Exit
    Social Stressors and Air Pollution Across New York City Communities: A Spatial Approach for Assessing Correlations Among Multiple Exposures | WE ACT for Environmental Justice Exit

    Progress and Final Reports:

    Original Abstract
  • 2011 Progress Report
  • 2012 Progress Report
  • 2013 Progress Report
  • Final Report