208150 Neighborhood-level characteristics and indoor allergens in the household

Wednesday, November 11, 2009: 9:15 AM

Lindsay E. Rosenfeld, SD, SM , Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA
Rima Rudd, MSPH, ScD , Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA
Ginger Chew, ScD , National Center for Environmental Health, Centers for Disease Control, Atlanta, GA
Karen M. Emmons, PhD , Department of Society, Human Development and Health/Division of Community-Based Research, Harvard School of Public Health/Dana-Farber Cancer Institute, Boston, MA
Dolores Acevedo-Garcia, PhD , School of Public Health, Harvard University, Boston, MA
Background: Most work concerning indoor allergens focuses on the relationship with the home environment. Questions remain about an association between the larger neighborhood-level environment and indoor allergens. We defined Bronx, NY neighborhoods as community districts, classified by the NY Department of City Planning for the organization of new and redevelopment projects.

Objective: We examined the relationship between neighborhood-level characteristics and concentrations of household dust mite (Der f 1), cat (Fel d 1), cockroach (Bla g 2), and mouse (MUP) allergens.

Methods: Using data from NYC Oasis, the Furman Center, and a birth cohort of Puerto Rican children at risk of allergic sensitization (n=261), we examined multivariable linear associations between neighborhood characteristics [percent tree canopy, asthma hospitalizations, roadway length, housing code violations, poverty and felony crime rate] and the presence of indoor allergens.

Results: In this session, we will discuss the development of a data set to examine these associations, particularly highlighting NYC Oasis and the Furman Center. In multivariable linear regression, adjusting for mother's income and education, and neighborhood characteristics, housing code violations were positively associated with dust mite, cat and mouse allergens. For example, medium levels of housing code violations were associated with dust mite (1.8, 95%CI: 1.1, 3.0) and cat allergens (3.1, 95%CI: 1.2, 7.9). Higher levels of housing code violations were associated with mouse allergen (2.0, 95%CI: 1.2, 3.6).

Conclusions: Future research explorations and policy decisions need to further consider the relationship between planning, (re)development, and health.

Learning Objectives:
1) By the end of the session, the participant will be able to explain the neighborhood level issues related to indoor allergens. 2) By the end of the session, the participant will be able to identify the potential impacts on health of neighborhood characteristics such as percent tree canopy, asthma hospitalizations, roadway length, housing code violations, poverty and felony crime rate, and consider what programs and policies might change these neighborhood-level characteristics. 3) By the end of the session, the participant will be able to describe measurement techniques relevant to the built environment such as GIS and NYC Oasis. 4) By the end of the session, the participant will be able to discuss the importance of considering planning and development issues when evaluating public health research, programs, and policy. 5) By the end of the session, the participant will be able to discuss neighborhood characteristics which may negatively or positively impact a health outcome of interest to them.

Keywords: Asthma, Policy/Policy Development

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: EDUCATION November 2008 Harvard School of Public Health, Boston, MA SD: Society, Human Development, and Health; Conc: Health and Social Policy; Major: Urban Health and Social Policy; Minors: Program Planning and Evaluation, Health Communications; Certificate: Women, Gender, and Health Focus: traditionally “non-health” policies that impact health, e.g. urban planning and design, housing, neighborhoods, education, (im)migration, and health literacy Dissertation: “Exploring Disparities in Asthma at Multiple Levels: Individual, Building, and Neighborhood Issues” June 2004 Harvard School of Public Health, Boston, MA SM: Health and Social Behavior Awards: Albert Schweitzer Fellowship and Rappaport Public Policy Fellowship May 2000 Brown University, Providence, RI AB with honors: Women’s Studies, magna cum laude, overall GPA: 3.9 Honors Thesis: gender, ethnicity, and social class in human service program design Honors: Phi Beta Kappa SOME RELEVANT EXPERIENCES: Oct 2008-present Postdoctoral Fellow, Harvard School of Public Health, Boston, MA  Continue research work with New England Family Study.  Explore new possibilities of research within health literacy and place-based disparity issues (i.e. regional equity, residential segregation, built environment).  Examine methods to explore current and potential non-health policies and programs that impact health. Sept 2008-present Research Associate, Harvard Clinical and Translational Science Center, Harvard Medical School, Boston, MA  Develop web portals as part of interdisciplinary team to 1) promote collaboration among Harvard science community and 2) provide access to information about clinical research for the community-at-large.  Develop evaluation study to examine usability and content of web portal for community-at-large. Oct 2007-present Research Associate, Maternal and Child Health State Policy Project, Harvard School of Public Health, Boston, MA  Aid in creation of State policy database.  Research and synthesize state lead law polices and their relationship to child health. Nov 2006-present Co-Founder, ICUPPH,Boston,MA Interdisciplinary Consortium on Urban Planning and Public Health  Lead interuniversity working group to address issues in public health, urban planning, and design.  Organize events to promote interaction and create awareness within the fields. June 2004-Aug 2008 Research Assistant for Dr. Dolores Acevedo-García Harvard School of Public Health, Boston, MA  Analyze housing and neighborhood context issues, using geocoding, ArcGIS, OASIS (NYC) for the National Institute of Environmental Health Sciences Puerto Rican Asthma Study. (June 2005 – present)  Conducted data analysis for “diversitydata.org” using the Neighborhood Change Database. (January 2005)  Aided in coordination of interdisciplinary symposium: Latino Health Paradoxes, conducted research, planned activities, and assisted in day’s events. (June 2004) Sept 2004-Aug 2008 Member, Child Health Impact Working Group, Boston Medical Center, Boston, MA  Participated in original vision and writing of Child Health Impact Assessments concerning affordable housing and energy assistance.  Participate in dissemination and policy strategy efforts. Sept 2003-June 2006 Member and Co-Chair, Div. of Public Health Practice Student Advisory Committee, Harvard School of Public Health, Boston, MA  Chair: Advised committee on functions and operations, facilitated monthly meetings, and coordinated subcommittees. (2003-2006)  Member: Organized seminars and speakers on public health practice; advised on public health practice issues. (2002-2003) Jan 2006 Participant, David Rockefeller Center for Latin American Studies - Field Study, University of Puerto Rico and Harvard University, San Juan, Puerto Rico  Contributed to classroom discussions with professors, fellow students, health officials, and organizations on topics including HIV/AIDS, mental health, and (im)migration in Puerto Rico and the Caribbean. June-Nov 2005 Spanish Bilingual Survey Assistant for Dr. Karen Emmons, Open Doors to Health, Dana Farber Cancer Institute/Harvard School of Public Health, Boston, MA  Visited low-income housing sites to interview residents about health issues.  Facilitated home visits, interviews, scheduling, and participant needs. Jan 2004 Participant, David Rockefeller Center for Latin American Studies - Field Study, Harvard School of Public Health, Santiago, Chile  Contributed to discussions and roundtables with health officials, administrators, and organizations concerning ‘AUGE’ health sector reform.  Conducted research and individual interviews for ongoing ‘social capital’ project spearheaded by local researchers at medical clinics and la Universidad Católica. June-Aug 2003 Policy and Program Coordinator (Rappaport Fellow), MA Dept. of Public Health (Div. of Violence and Injury Prevention), Boston, MA  Developed youth violence policy recommendations, and created publicly-available, user-friendly youth violence web materials.  Worked with CDC-funded, violence prevention collaborative program model in 3 racial/ethnic minority communities across the state to facilitate a reflection and development process for project work plans. SAMPLE OF PRESENTATIONS: Feb 2008 Guest Lecturer, Harvard Graduate School of Design, Cambridge, MA “Housing and Health: What do we know about the relationship and what are the implications”  Presented public health concepts to Housing Design Course, engaging students in discussion of how design and planning are related to, and impact, health. Apr 2007/2008 Guest Lecturer, Boston University School of Public Health, Boston, MA May 2006/2007 “GIS and Health Impact Assessment: Methods for Public Health”  Presented Geographic Information Systems and Health Impact Assessment concepts, analyzing innovations and challenges of methods. Nov 2007 135th American Public Health Association Meeting, Washington, DC “Puerto Ricans in the Bronx, NY: Sociocontextual influences on asthma – building and neighborhood type”  Presented orals session entitled: ‘Strategies to Reduce Asthma Disparities,’ participated in panel discussion. May 2008 Guest Lecturer, Harvard School of Public Health, Boston, MA April 2007/2006 “Health Impact Assessment as a Policy Method”  Presented Health Impact Assessment method to policy courses, analyzing innovations and challenges of the method. May 2007 3rd Annual Puerto Rican Public Health Conference, San Juan, Puerto Rico “Puerto Ricans in the Bronx, NY: Building and neighborhood characteristics and respiratory illness”  Presented in ‘Cultural Diversity’ orals sessions, participated in panel discussion.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.