Neighborhood Deprivation and Respiratory Conditions in Mexican American Children

Evidence suggests that the neighborhood social environment may contribute to childhood respiratory conditions but there is limited research on multilevel determinants of these conditions in Mexican American (MA) children. In addition, the limited research linking neighborhood contextual poverty with respiratory conditions in Hispanic populations shows inconsistent findings. The purpose of this analysis was to examine the associations of neighborhood deprivation (ND) with the risk of wheezing and other respiratory conditions in a sample of MA children. Identifying neighborhood level factors associated with respiratory symptoms is essential to the design of multilevel strategies to prevent/control these conditions.  

In this cross-sectional multilevel study, we used Geographic Information Systems software to geocode addresses of 2,023 children of Mexican descent for whom we previously collected information on individual-level characteristics. These variables included children’s history of respiratory conditions and other covariates.  We then aggregated data on neighborhood socioeconomic and demographic variables at the census tract level and linked individual and neighborhood level characteristics. Neighborhood deprivation was created as a composite of the following six neighborhood-level variables: the percentage of adults older than 25 years with less than a high school education; percentage of unemployed males; percentage of families below the poverty line; percentage of individuals receiving public assistance; percentage of female-headed households; and median household income. Each variable was standardized (mean=0, standard deviation=1) prior to creation of the composite variable. We performed a series of mixed-effect binary logistic regression analyses with a random intercept for each neighborhood. 

We found that ND was significantly associated with a reduced odds of lifetime history of wheezing. For each one standard deviation increase in ND, we observed a 15% reduction in the odds of ever wheezing. This association persisted after controlling for individual-level factors including age, gender, and country of birth (OR=0.86, 95% CI=0.77-0.97, p<0.016). The associations of ND with lifetime asthma diagnosis as well as asthma symptoms were not statistically significant. 

Neighborhood socioeconomic disadvantage was associated with a reduced risk of lifetime wheezing. These findings suggest that factors related to ND might convey protection against wheezing in urban children of Mexican origin. More research is needed to further elucidate these factors and examine how contextual neighborhood characteristics interact with individual level variables to affect the risk of respiratory conditions in MA children.