A structural model of high crime neighborhoods as a driver of toxic stress leading to asthma diagnoses among children of a large medical practice. (September 2021)

• Record Type: Journal Article
• Authors: Merrill, April; Paracha, Alizay; Hemming, Eden; Hendrix, Amy; Munoz, Ric; Couch, Taylor; Gent, Carmen; Gill, Mohsain; Homco, Juell; Schaefer, Shawn
• Is Part Of: Health & place. Volume 71(2021)
• Publication Date: 2021-09
• Subjects: Pediatrics -- Asthma -- Crime -- Toxic stress -- Social determinants of health; Health -- Social aspects -- Periodicals; Health services accessibility -- Periodicals; Public health -- Periodicals; Political planning -- Periodicals; Social medicine -- Periodicals; Epidemiology -- Periodicals; Health Policy -- Periodicals; Health Services Accessibility -- Periodicals; Public Health -- Periodicals; Public Policy -- Periodicals; Sociology, Medical -- Periodicals; Épidémiologie -- Périodiques; Politique sanitaire -- Périodiques; Santé, Services de -- Accessibilité -- Périodiques; Health services accessibility; Health -- Social aspects; Political planning; Public health; Social medicine; Periodicals; 613
• DOI: 10.1016/j.healthplace.2021.102665
• Languages: English
• ISSNs: 1353-8292

Abstract

Abstract: This study tested the relationship of neighborhood crime as a driver of pediatric asthma diagnoses via the mechanism of toxic stress utilizing data from a police department, and pediatric clinic in a large urban city in the southwestern United States. Using structural equation modeling, a full mediation model of neighborhood crime as a driver of toxic stress resulting in increased asthma diagnoses fit the data well ( Χ 2 = 14.0, p =.371; df = 13; RMSEA = .028 [90% CI: 0.00, 0.102]; CFI: 0.995; SRMR = .053). Advocates should explore ways to reduce neighborhood crime to address toxic stress and asthma. Highlights: The mechanism linking neighborhood crime and asthma is poorly understood. Social determinants of health paradigm and allostatic load theory may explain the link. Structural equation modeling tested toxic stress as a link between crime and asthma. The hypothesized model fit crime, stress, and pediatric asthma diagnoses in Tulsa, OK. Further research is needed regarding environmental stressors and health outcomes.