Final 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 , Onokpise, Oghenekome U. , Ito, Kazuhiko , Shepard, Peggy
Institution: University of Pittsburgh , West Harlem Environmental Action (WE ACT for Environmental Justice) , New York University School of Medicine , 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 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 aimed to understand relative spatial distributions in key community-level psychosocial stressors and air pollution exposures across New York City, and to examine their separate and synergistic effects of childhood asthma exacerbation.

Summary/Accomplishments (Outputs/Outcomes):

For this project, we identified and collected a suite of publicly-available administrative indicators of chronic social stressors across all New York City (NYC) communities (Table 1). We applied geographic information systems (GIS)-based methods to: (1) examine spatial correlations among these stressors and with indicators of socioeconomic position (SEP), (2) identify groups of spatially-correlated stressors, (3) test for significant spatial autocorrelations within all variable, and (4) examine spatial correlations between stressors and multiple air pollutants. To compare administrative data reported at very different geographies (e.g., census tracts, police precincts), we developed and validated methods for re-aggregating data to a common spatial unit. Ultimately, we identified three salient, distinct groups of spatially-correlated stressors ("factors"), characterized by: (1) extreme deprivation and violent crime, (2) poor housing conditions, and (3) property crimes and complaints regarding noise and poor air quality.

To better understand and validate these geostatistical analyses, we implemented two methods for assessing perceptions of stressors: 1) citywide community focus groups, and 2) a spatially-stratified citywide survey on perceived community exposures to stressors and chronic stress. First, we first designed and conducted a city-wide focus group process to identify key community stressors of concern to residents from all five (5) New York City (NYC) boroughs. Focus groups were conducted in English and Spanish, and we included one youth focus group in each borough.

Using insights from these focus group conversations, we developed and implemented a city-wide systematic random-digit-dial phone survey among NYC adults (n = 1,589) to assess residents' perceptions of stressor prevalence in their community, and to capture individual-level measures of perceived stress, mental health, and asthma outcomes. For those focus group participants and survey respondents using the web-based interface, we solicited data on self-described neighborhood boundaries, to capture "organic" neighborhood boundaries in NYC, and compare these to the various administrative data scales.

Comparing the GIS-based stressor indicators to the citywide survey data, we identified those community-level social stressor indicators which best predicted individual chronic stress. Community-level indicators of violent crime (e.g., felony assault, murder)—but not property-related crimes, physical disorder (e.g., rental unit housing violations), noise disruption, or low socioeconomic position (SEP) (e.g., less than High School education)—were significantly associated with both individual perceptions of neighborhood disorder and with individual perceived stress. We thereby interpreted these violent crime indicators as "validated" as indicators of chronic stress, according to our methods.

To examine the role of community stressors as potential modifiers of the association between air pollution and asthma exacerbations, we conducted two types of epidemiologic analyses. First, we performed an ecologic analysis of annual-average nitrogen dioxide (NO2) concentrations and community-level asthma hospitalization rates, with modification by median-dichotomized versions of each of the three stressor patterns ("factors") identified in GIS. Second, we performed a much richer analysis using case-crossover methods, and daily citywide data on asthma hospitalizations (n = 2,353) and Emergency Department (ED) visits (n = 11,719) among children aged 5 to 17 years during the warm season (June-August) of 2005-2011. We created day- and residence-specific air pollution exposure estimates using highly spatially-resolved intra-urban concentration surfaces for ozone, co-pollutants [NO2 and fine particulate matter (PM2.5)], and minimum daily temperature from the New York City Community Air Survey (NYCCAS), and b) EPA daily regulatory monitoring data. We used conditional logistic regression to model associations between ozone and asthma exacerbations for lag days 0 to 6, adjusting for co-pollutants and temperature. Testing each of the three stressor factors and community violent crime rates as median-dichotomized effect modifiers, we generally observed stronger associations between ozone and asthma risk, particularly on lag days 1-3, in communities with elevated rates of violent crime or lower SEP.

Under our community outreach and engagement efforts, WE ACT convened the New York City Community Air Network (NYCCAN) to engage diverse stakeholders—including community-based organizations (CBOs), environmental health advocates, academic researchers, and government agencies—in an on-going discussion around issues of social stress and chemical exposures, to foster a rich discussion on environmental justice issues which included both social and physical environmental issues, towards shaping future research agendas and environmental health science translation. Our community-based participatory research strategy, and early scientific learnings were presented and discussed among NYCCAS stakeholders at several meetings in NYC. In addition, focus group findings were summarized in posters distributed to, and displayed by, community partner organizations who hosted focus groups and/ or supported recruitment.


Journal Articles on this Report : 7 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)
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  • Journal Article Payne-Sturges DC, Korfmacher KS, Cory-Slechta DA, Jimenez M, Symanski E, Carr Shmool JL, Dotson-Newman O, Cloughtery JE, French R, Levy JI, Laumbach R, Rodgers K, Bongiovanni R, Scammell MK. Engaging communities in research on cumulative risk and social stress-environment interactions: lessons learned from EPA's STAR Program. Environmental Justice 2015;8(6):203-212. R834576 (Final)
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  • Journal Article Reid C, Clougherty J, Schmool J, Kubzansky L. Is All Urban Green Space the Same? A Comparison of the Health Benefits of Trees and Grass in New York City. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017;14(11):1411. R834576 (Final)
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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)
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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)
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  • Journal Article Shmool JLC, Bobb JF, Ito K, Elston B, Savitz DA, Ross Z, Matte TD, Johnson S, Dominici F, Clougherty JE. Area-level socioeconomic deprivation, nitrogen dioxide exposure, and term birth weight in New York City. Environmental Research 2015;142:624-632. R834576 (Final)
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  • Journal Article Shmool JLC, Kinnee E, Sheffield PE, Clougherty JE. Spatio-temporal ozone variation in a case-crossover analysis of childhood asthma hospital visits in New York City. Environmental Research 2016;147:108-114. R834576 (Final)
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  • Supplemental Keywords:

    community stressors, psychosocial stress, synergistic effects, nonchemical stressors, traffic-related air pollution, childhood asthma exacerbation, differential susceptibility, spatial epidemiology, geographic information systems, GIS

    Relevant Websites:

    Jane E. Clougherty | Environmental and Occupational Health | University of Pittsburgh Graduate School of Public Health Exit

    Progress and Final Reports:

    Original Abstract
  • 2011 Progress Report
  • 2012 Progress Report
  • 2013 Progress Report
  • 2014 Progress Report