Trajectories of neighborhood environmental factors and their associations with asthma symptom trajectories among children in Australia: evidence from a national birth cohort study

Abstract

Abstract Purpose This study aims to investigate the prospective associations of neighborhood environmental exposure trajectories with asthma symptom trajectories during childhood developmental stages. Methods We considered asthma symptom, neighborhood environmental factors, and socio-demographic data from the “Longitudinal Study of Australian Children (LSAC)”. Group-based trajectory modeling was applied to identify the trajectories of asthma symptom, neighborhood traffic conditions, and neighborhood livability scales (considered for safety and facilities). We used multivariable logistic regression models to assess associations between various neighborhood environmental factors and asthma symptom trajectories. Results We included 4,174 children from the LSAC cohort in our study. Three distinct trajectories for asthma symptom were the outcome variables of this study. Among the neighborhood environmental factors, we identified two distinct trajectories for the prevalence of heavy traffic on street, and two trajectories of neighborhood liveability scale. Compared to the ‘Low/no’ asthma symptoms trajectory group, children exposed to a ‘persistently high’ prevalence of heavy traffic on street was also significantly associated with both ‘transient high’ [relative risk ratio (RRR):1.40, 95% CI:1.25,1.58) and ‘persistent high’ (RRR: 1.33, 95% CI:1.17,1.50)] asthma symptom trajectory groups. Trajectory of moderate and static neighborhood liveability score was at increased risk of being classified as ‘transient high’ (RRR:1.16, 95% CI:1.07,1.25) and ‘persistent high’ (RRR:1.38, 95% CI:1.27,1.50) trajectories of asthma symptom. Conclusion Exposure to heavy traffic and poor neighborhood liveability increased the risk of having an unfavourable asthma symptom trajectory in childhood. Reducing neighborhood traffic load and improving neighborhood safety and amenities may facilitate a favorable asthma symptom trajectory among these children.