Neighborhood Effects on Acute Pediatric Asthma: Race, Greenspace, and PM2.5

Urbanization produces spatially variable landscapes where climatic, environmental, and social systems interact in complex ways that affect public health. Environmental exposure along with the associated health risks are unevenly distributed and communities of color are often disproportionately affected by poor health outcomes. Acute pediatric asthma is the most common chronic condition of childhood in developed nations and is especially prevalent in minority and low-income children. In this study, we analyze the spatial variability of neighborhood-level acute pediatric asthma emergency department (ED) visits across the Kansas City Metro Area. Using Bayesian negative binomial regression, we describe the relationships and interactions between race, low income, fractional vegetation, and PM2.5. We find significant disparities in acute pediatric asthma incidence in census tracts with different levels of poverty and percentages of non-White populations, even after accounting for neighborhood economic position. We also find that higher PM2.5 concentrations are associated with increased asthma ED visits and that a high percentage of vegetative cover reduces this effect in high-pollution neighborhoods. The magnitude of this protective effect is stronger in neighborhoods with a high proportion of non-White residents. These results suggest that investing in greenspace infrastructure may reduce the deleterious effects of PM2.5 and provide health benefits, especially in neighborhoods of color.