Population and Environment

, Volume 40, Issue 2, pp 93–114 | Cite as

Neighborhood and social environmental influences on child chronic disease prevalence

  • Ashley W. KranjacEmail author
  • Justin T. Denney
  • Rachel T. Kimbro
  • Brady S. Moffett
  • Keila N. Lopez
Original Paper


We investigate how distinct residential environments uniquely influence chronic child disease prevalence. Aggregating over 200,000 pediatric geocoded medical records to the census tract of residence and linking them to neighborhood-level measures, we use multiple data analysis techniques to assess how heterogeneous exposures of social and environmental neighborhood conditions influence an index of child chronic disease (CCD) prevalence for the neighborhood. We find there is a graded relationship between degree of overall neighborhood disadvantage and children’s chronic disease such that the highest neighborhood CCD scores are found in communities with the highest concentrated disadvantage. After considering individual- and family-level characteristics, results show that higher levels of neighborhood concentrated disadvantage and air pollution exposure associate with higher risks of children having at least one chronic condition. Overall, our analysis serves as a comprehensive start for future researchers interested in assessing which neighborhood factors matter most for child chronic health conditions.


Child chronic disease Concentrated disadvantage Pollution exposure Neighborhoods 



The authors thank Kristin Osiecki for her help with the environmental air quality data and Mackenzie Brewer, Jean Aroom, and Naomi Hausman for their help with the maps.

Funding information

Houston Endowment (2012-249-0270), Dr. Rachel T. Kimbro.

Compliance with ethical standards

The research was conducted in accord with prevailing ethical principles and reviewed by the Rice University and Baylor College of Medicine Institutional Review Boards.

Conflict of interest

The authors declare that they have no conflict of interest.


  1. Allison, P. D. (2001). Missing data (Vol. 136). Thousand Oaks: Sage publications.Google Scholar
  2. Almgren, G., Guest, A., Imerwahr, G., & Spittel, M. (1998). Joblessness, family disruption, and violent death in Chicago, 1970–1990. Social Forces, 76(4), 1465.CrossRefGoogle Scholar
  3. Akinbami, L. J., Lynch C. D., Parker J. D., Woodruff, T. J. (2010). The association between childhood asthma prevalence and monitored air pollutants in metropolitan areas, United States, 2001–2004. Environmental Research, 110, 294–301.CrossRefGoogle Scholar
  4. Arcaya, M., Tucker-Seeley, R., Kim, R., Schnake-Mahl, A., So, M., & Subramanian, S. (2016). Research on neighborhood effects on health in the United States: a systematic review of study characteristics. Social Science & Medicine, 168, 16–29.CrossRefGoogle Scholar
  5. Ayanian, J. Z., Kohler, B. A., Abe, T., & Epstein, A. M. (1993). The relation between health insurance coverage and clinical outcomes among women with breast cancer. The New England Journal of Medicine, 329, 326–331.CrossRefGoogle Scholar
  6. Bell, M. L., & Ebisu, K. (2012). Environmental inequality in exposures to airborne particulate matter components in the United States. Environmental Health Perspectives, 120(12), 1699–1704.CrossRefGoogle Scholar
  7. Bell, M. L., Zanobetti, A., & Dominici, F. (2014). Who is more affected by ozone pollution? A systematic review and meta-analysis. American Journal of Epidemiology, 180(1), 15–28.CrossRefGoogle Scholar
  8. Berens, A. E., Jensen, S. K. G., & Nelson, C. A. (2017). Biological embedding of childhood adversity: from physiological mechanisms to clinical implications. BMC Medicine, 15(1), 135.CrossRefGoogle Scholar
  9. Bock, R. D., & Aitkin, M. (1981). Marginal maximum likelihood estimation of item parameters: an application of the emalgorithm. Psychometrika, 46, 443–459.CrossRefGoogle Scholar
  10. Brochu, P. J., Yanosky, J. D., Paciorek, C. J., Schwartz, J., Chen, J. T., Herrick, R. F., & Suh, H. H. (2011). Particulate air pollution and socioeconomic position in rural and urban areas of the Northeastern United States. American Journal of Public Health, 101(S1), S224–S230.CrossRefGoogle Scholar
  11. Brooks-Gunn, J., Duncan, G. J., Klebanov, P. K., & Sealand, N. (1993). Do neighborhoods influence child and adolescent development. The American Journal of Sociology, 99(2), 353–395.CrossRefGoogle Scholar
  12. Brooks-Gunn, J., Duncan, G. J., & Aber, J. L. (Eds.). (1997). Neighborhood poverty: vol. I: context and consequences for children. New York: Russell Sage Found.Google Scholar
  13. Brown, A. F., Vargas, R. B., Ang, A., & Pebley, A. R. (2008). The neighborhood food resource environment and the health of residents with chronic conditions. The Journal of Internal Medicine, 23(8), 1137–1144.Google Scholar
  14. Brown, A. F., Morris, D. M., Kahn, K. L., Sankaré, I. C., King, K. M., Vargas, R., Norris, K. C. (2016). The healthy community neighborhood initiative: rationale and design. Ethnicity & Disease, 26(1), 123–132. Scholar
  15. Bullard, R. D., & Johnson, G. S. (2000). Environmentalism and public policy: environmental justice: grassroots activism and its impact on public policy decision making. Journal of Social Issues, 56, 555–578.CrossRefGoogle Scholar
  16. Chakraborty, J., Maantay, J. A., & Brender, J. D. (2011). Disproportionate proximity to environmental health hazards: methods, models, and measurement. American Journal of Public Health, 101(Suppl 1), S27–S36.CrossRefGoogle Scholar
  17. Crowder, K., & Downey, L. (2010). Inter-neighborhood migration, race, and environmental hazards: modeling micro-level processes of environmental inequality. The American Journal of Sociology, 115(4), 1110–1149.CrossRefGoogle Scholar
  18. Currie, C., Roberts, C., Morgan, A., Smith, R., Settertobulte, W., Samdal, O., & Rasmussen, V. (2011). Young people’s health in context. Health Policy for Children and Adolescents, 4, 1–248.Google Scholar
  19. Diez Roux, A. V. (2001). Investigating neighborhood and area effects on health. American Journal of Public Health, 91, 1783–1789.CrossRefGoogle Scholar
  20. Diez Roux, A. V., & Mair, C. (2010). Neighborhoods and health. Annals of the New York Academy of Sciences, 1186, 125–145.CrossRefGoogle Scholar
  21. Diez-Roux, A. V., Nieto, F. J., Muntaner, C., Tyroler, H. A., Comstock, G. W., Shahar, E., et al. (1997). Neighborhood environments and coronary heart disease: a multilevel analysis. American Journal of Epidemiology, 146(1), 48–63.CrossRefGoogle Scholar
  22. Downey, L. (2006). Environmental racial inequality in Detroit. Social Forces, 85(2), 771–796.CrossRefGoogle Scholar
  23. Drukker, D. M., Prucha, I. R., & Raciborski, R. (2013). Maximum likelihood and generalized spatial two-stage least-squares estimators for a spatial-autoregressive model with spatial-autoregressive disturbances. The Stata Journal, 13, 221–241.CrossRefGoogle Scholar
  24. Fann, N., Roman, H. A., Fulcher, C. M., Gentile, M. A., Hubbell, B. J., Wesson, K., & Levy, J. I. (2011). Maximizing health benefits and minimizing inequality: incorporating local-scale data in the design and evaluation of air quality policies. Risk Analysis, 31(6), 908–922.CrossRefGoogle Scholar
  25. Foraker, R. E., Rose, K. M., Whitsel, E. A., Suchindran, C. M., Wood, J. L., & Rosamond, W. D. (2010). Neighborhood socioeconomic status, Medicaid coverage and medical management of myocardial infarction: atherosclerosis risk in communities (ARIC) community surveillance. BMC Public Health, 10, 632.CrossRefGoogle Scholar
  26. Foster, S. & Giles‐Corti, B. (2008). The built environment, neighborhood crime and constrained physical activity: an exploration of inconsistent findings. Preventive Medicine, 47, 241–251.CrossRefGoogle Scholar
  27. Freedman, V. A., Grafova, I. B., & Rogowski, J. (2011). Neighborhoods and chronic disease onset in later life. American Journal of Public Health, 101(1), 79–86.CrossRefGoogle Scholar
  28. Gordon, N. P., & Mellor, R. G. (2015). Accuracy of parent-reported information for estimating prevalence of overweight and obesity in a race-ethnically diverse pediatric clinic population aged 3 to 12. BMC Pediatrics, 15(5), 1–11.Google Scholar
  29. Grafova, I. B., et al. (2008). Neighborhoods and obesity in later life. American Journal of Public Health, 98, 2065–2071.CrossRefGoogle Scholar
  30. Greggo, J., Jones, S. E., & Kann, L. (2005). Population density and alcohol-related risk behaviors among US high school students. American Journal of Health Education, 36(3), 148–154.CrossRefGoogle Scholar
  31. Guarnieri, M. & Balmes, J. R. (2014). Outdoor air pollution and asthma. Lancet, 383(9928), 1581–1592.CrossRefGoogle Scholar
  32. Harding, D. J., Gennetian, L., Winship, C., Sanbonmatsu, L., & Kling, J. (2011). Unpacking neighborhood influences on education outcomes: setting the stage for future research. NBER Work. Pap. 1605, National Bureau of Economic Research. Cambridge, MA.Google Scholar
  33. Harnick, D. J., Cohen, J. L., Schechter, C. B., Fuster, V., & Smith, D. A. (1998). Effects of practice setting on quality of lipid-lowering management in patients with coronary artery disease. The American Journal of Cardiology, 81, 1416–1420.CrossRefGoogle Scholar
  34. Hedeker, D. (2003). A mixed-effects multinomial logistic regression model. Statistics in Medicine, 22(9), 1433–1446.CrossRefGoogle Scholar
  35. Huang, P., Li, W., & Parrish, R. (2008). Chronic disease in Texas: a surveillance report of disease indicators. Department of State Health Services: Health Promotion Unit Publication number: E81–11194.Google Scholar
  36. Jargowsky, P. A. (1997). Poverty and place: ghettos, barrios, and the American City. New York: Russell Sage Foundation.Google Scholar
  37. Jencks, C., & Mayer, S. E. (1990). The social consequences of growing up in a poor neighborhood. In L. E. Lynn & M. G. H. McGeary (Eds.), Inner city poverty in the United States (p. 111e186). Washington, DC: National Academy.Google Scholar
  38. Juhn, Y. J., St. Sauver, J., Katusic, S., Vargas, D., Weaver, A., & Yunginger, J. (2005). The influence of neighborhood environment on the incidence of childhood asthma: a multilevel approach. Social Science & Medicine, 60, 2543–2464.CrossRefGoogle Scholar
  39. Juonala, M., Juhola, J., Magnussen, C. G., Würtz, P., Viikari, J. S. A., Thomson, R., & Raitakari, O. T. (2011). Childhood environmental and genetic predictors of adulthood obesity: the Cardiovascular Risk in Young Finns Study. The Journal of Clinical Endocrinology and Metabolism, 96(9), E1542–E1549.CrossRefGoogle Scholar
  40. Kimbro, R. T., & Denney, J. T. (2013). Neighborhood context and racial/ethnic differences in young children’s obesity: structural barriers to interventions. Social Science & Medicine, 95, 97–105.CrossRefGoogle Scholar
  41. King, K. E. (2015). Chicago residents’ perceptions of air quality: objective pollution, the built environment, and neighborhood stigma theory. Population and Environment, 37, 1–21.CrossRefGoogle Scholar
  42. King, K. E., & Clarke, P. J. (2015). A disadvantaged advantage in walkability: findings from socioeconomic and geographical analysis of National Built Environment Data in the United States. American Journal of Epidemiology, 181(1), 17–25.CrossRefGoogle Scholar
  43. Lazarsfeld, P. F., & Henry, N. W. (1968). Latent structure analysis. Boston: Houghton Mifflin.Google Scholar
  44. Leinberger, C. B. (2013). The WalkUP wake-up call: Atlanta. Washington, DC: The George Washington University School of Business.Google Scholar
  45. Levy, J. I., Wilson, A. M., & Zwack, L. M. (2007). Quantifying the efficiency and equity implications of power plant air pollution control strategies in the United States. Environmental Health Perspectives, 115(5), 743–750.CrossRefGoogle Scholar
  46. Lewis, V. A., Emerson, M. O., & Klineberg, S. L. (2011). Who we’ll live with: neighborhood racial composition preferences of Whites, Blacks and Latinos. Social Forces, 89(4), 1385–1407.CrossRefGoogle Scholar
  47. Leyden, K. M. (2003). Social capital and the built environment: the importance of walkable neighborhoods. American Journal of Public Health, 93(9), 1546–1551.CrossRefGoogle Scholar
  48. Lin, M., Chen, Y., Villeneuve, P. J., Burnett, R. T., Lemyre, L., Hertzman, C., McGrail, K. M., & Krewski, D. (2004). Gaseous air pollutants and asthma hospitalization of children with low household income in Vancouver, British Columbia, Canada. American Journal of Epidemiology, 159(3), 294–303.CrossRefGoogle Scholar
  49. Lippert, A. M. (2016). Stuck in unhealthy places: how entering, exiting, and remaining in poor and nonpoor neighborhoods is associated with obesity during the transition to adulthood. Journal of Health and Social Behavior, 57(1), 1–21.CrossRefGoogle Scholar
  50. Massey, D. S., Gross, A. B., & Shibuya, K. (1994). Migration, segregation, and the geographic concentration of poverty. American Sociological Review, 59, 425–445.CrossRefGoogle Scholar
  51. Miranda, M. L., Edwards, S. E., Keating, M. H., & Paul, C. J. (2011). Making the environmental justice grade: the relative burden of air pollution exposure in the United States. International Journal of Environmental Research and Public Health, 8(6), 1755–1771.CrossRefGoogle Scholar
  52. Morenoff, J. D. (2003). Neighborhood mechanisms and the spatial dynamics of birth weight. The American Journal of Sociology, 108(5), 976–1017.CrossRefGoogle Scholar
  53. O’Campo, P., Xue, X., Wang, M. C., & Caughy, M. (1997). Neighborhood risk factors for low birthweight in Baltimore: a multilevel analysis. American Journal of Public Health, 87(7), 1113–1118.CrossRefGoogle Scholar
  54. Oakes, J. M., Forsyth, A., & Schmitz, K. H. (2007). The effects of neighborhood density and street connectivity on walking behavior: the Twin Cities walking study. Epidemiologic Perspectives & Innovations, 4, 16.CrossRefGoogle Scholar
  55. Oakes, J. M., Andrade, K. E., Biyoow, I. M., et al. (2015). Twenty years of neighborhood effect research: an assessment. Current Epidemiology Reports, 2, 80–87.CrossRefGoogle Scholar
  56. Patel, C. J., & Ioannidis, J. P. (2014). Studying the elusive environment in large scale. JAMA, 311(21), 2173–2174.CrossRefGoogle Scholar
  57. Pope, C. A., & Dockery, D. W. (2006). Health effects of particulate air pollution: lines that connect. Journal of Air and Waste Management, 56, 709–742.CrossRefGoogle Scholar
  58. Pulcini, C. D., Zima, B. T., Kelleher K J., Houtrow A. J. (2017). Poverty and trends in 3 common chronic disorders. Pediatrics, 140(5), e20173005.Google Scholar
  59. Rodriquez, M., & Alexeeff, G. V. (2014). California communities environmental health screening tool, version 2.0.
  60. Rosenbaum, S. (2002). Medicaid. The New England Journal of Medicine, 346, 635–640.CrossRefGoogle Scholar
  61. Ross, C. E., & Mirowsky, J. (2001). Neighborhood disadvantage, disorder, and health. Journal of Health and Social Behavior, 42(3), 258–276.CrossRefGoogle Scholar
  62. Saelens, B. E., & Handy, S. L. (2008). Built environment correlates of walking: a review. Medicine and Science in Sports and Exercise, 40, S550–S566.CrossRefGoogle Scholar
  63. Sampson, R. J. (2003). The neighborhood context of well-being. Perspectives in Biology and Medicine, 46(3), S53–S64.CrossRefGoogle Scholar
  64. Sampson, R. J. (2008). Moving to inequality: Neighborhood effects and experiments meet structure. American Journal of Sociology, 114(11), 189–231.CrossRefGoogle Scholar
  65. Sampson, R. J., & Sharkey, P. (2008). Neighborhood selection and the social reproduction of concentrated racial inequality. Demographics, 45, 1–29.CrossRefGoogle Scholar
  66. Sampson, R. J., Raudenbush, S. W., & Earls, F. (1997). Neighborhoods and violent crime: a multilevel study of collective efficacy. Science, 277, 918–924.CrossRefGoogle Scholar
  67. Sampson, R. J., Morenoff, J. D., & Gannon-Rowley, T. (2002). Assessing “neighborhood effects”: social processes and new directions in research. Annual Review of Sociology, 28, 443–478.CrossRefGoogle Scholar
  68. Sampson, R. J., Sharkey, P., & Raudenbush, S. (2008). Durable effects of concentrated disadvantage on verbal ability among African-American children. Proceedings of the National Academy of Sciences of the United States of America, 105, 845–852.CrossRefGoogle Scholar
  69. Sexton, K., Linder, S., Abramson, S., Bondy, M., Delclos, G, Fraser, M., et al. (2006) A closer look at air pollution in Houston: identifying priority health risks, report of the Mayor’s Task Force on the Health Effects of Air Pollution; Institute for Health Policy Report ES-001-006.Google Scholar
  70. Sharkey, P. (2010). The acute effect of local homicides on children’s cognitive performance. Proceedings of the National Academy of Sciences of the United States of America, 107, 11733–11738.CrossRefGoogle Scholar
  71. Shen, J. J., Wan, T. T., & Perlin, J. B. (2001). An exploration of the complex relationship of socioecologic factors in the treatment and outcomes of acute myocardial infarction in disadvantaged populations. Health Services Research, 36, 711–732.Google Scholar
  72. StataCorp. (2017). Stata: release 15. Statistical software. College Station: StataCorp LLC.Google Scholar
  73. Sundquist, K., Eriksson, U., Kawakami, N., Skog, L., Ohlsson, H., & Arvidsson, D. (2011). Neighborhood walkability, physical activity, and walking behavior: the Swedish Neighborhood and Physical Activity (SNAP) study. Social Science & Medicine, 72(8), 1266–1273.CrossRefGoogle Scholar
  74. Tabarrok, A., Healton, P., & Helland, E. (2010). The measure of vice and sin: a review of the uses, limitations, and implication of crime data. In Handbook on the economics of crime. Northhampton: Edward Elgar Publishing.Google Scholar
  75. Tienda, M. (1991). Poor people and poor places: deciphering neighborhood effects on poverty outcomes. In J. Huber (Ed.), Macro-micro linkages in sociology (pp. 244–262). Newbury Park: Sage.Google Scholar
  76. Torpy, J. M., Campbell, A., & Glass, R. M. (2010). Chronic diseases of children. JAMA, 303(7), 682.CrossRefGoogle Scholar
  77. Van Cleave, J., Gortmaker, S. L., Perrin, J. M. (2010). Dynamics of obesity and chronic health conditions among children and youth. JAMA, 303(7), 623.CrossRefGoogle Scholar
  78. Vartanian, T. P., & Houser, L. (2010). The effects of childhood neighborhood conditions on self-reports of adult health. Journal of Health and Social Behavior, 51(3), 291–306.CrossRefGoogle Scholar
  79. White, M. J. (1987). American neighborhoods and residential differentiation. New York: Russell Sage Foundation.Google Scholar
  80. Wilson, W. J. (1987). The truly disadvantaged: the inner city, the underclass, and public policy. Chicago: Univ. Chicago Press.Google Scholar
  81. Winning, A., Glymour, M., McCormick, M., Gilsanz, P., & Kubzansky, L. (2016). Childhood psychological distress as a mediator in the relationship between early-life social disadvantage and adult cardiometabolic risk: evidence from the 1958 British birth cohort. Psychosomatic Medicine, 78(9), 1019–1030.CrossRefGoogle Scholar

Copyright information

© Springer Nature B.V. 2018

Authors and Affiliations

  • Ashley W. Kranjac
    • 1
    Email author
  • Justin T. Denney
    • 2
  • Rachel T. Kimbro
    • 3
  • Brady S. Moffett
    • 4
  • Keila N. Lopez
    • 5
  1. 1.Department of SociologyChapman UniversityOrangeUSA
  2. 2.Department of SociologyWashington State UniversityPullmanUSA
  3. 3.Department of Sociology, Kinder Institute Urban Health ProgramRice UniversityHoustonUSA
  4. 4.Pain MedicineBaylor College of MedicineHoustonUSA
  5. 5.Heart Center, CardiologyTexas Children’s Hospital, Baylor College of MedicineHoustonUSA

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