Examining place effects and asthma in an adult population: Zip codes, fast food and asthma

Background: Several studies have identified place effects for asthma incidence.

Purpose: Explore the link between the physical community environment (ZIP Codes and density of fast food outlets) and asthma in an adult population.

Methods: We developed the “Speak to Your Health!” Community Survey following community based research principles. Data are collected biennially for the county-wide health survey and are demographically representative of the county. We utilized descriptive statistics, a path analysis to examine the relationship between fast food density and asthma, and hierarchal linear modeling.

Results: Mean age of the sample (N = 1748) was 55 (SD=16); 66% of the population was White, 26% African American, and 7% other race/ethnicity; and 15% of the population had a diagnosis of asthma. We found significant differences in asthma prevalence by zip code. The longer participants resided within a high asthma prevalence zip code, the more likely they were to have asthma. Women and those with higher BMIs were also more likely to have an asthma diagnosis. The local concentration of fast food outlets was associated with a higher BMI and a diagnosis of asthma (mediated path). We also found a direct positive association between local concentration of fast food outlets and the likelihood of having a diagnosis of asthma.

Conclusions: We found significant associations between place effects and asthma in the adult population. Clinicians and researchers should be aware of the potential contribution and influence of place effects, including length of residency and neighborhood configuration, on asthma.