Geospatial-based neighborhood hazards and asthma risk in adults: interaction with social vulnerability

BackgroundVarious residential hazards have been associated with asthma risk, with socially disadvantaged neighborhoods disproportionately affected by environmental exposures. This study aimed to explore geospatial-based neighborhood hazards and estimate their mixture effect on adult asthma risk by social vulnerability index (SVI). Materials and MethodsThis cross-sectional study included 7092 adults from a North Carolina-based cohort (2013-2022). Adult asthma was defined as self-reported an asthma diagnosis with recurrent attacks in adulthood. Exposure to 29 residential hazards was estimated using spatiotemporal models and hazard maps, including multiple air pollutants, volatile organic compound emissions, highway density, and proximity to pollutant sources. The census tract-based SVI was assigned to participants residences. Associations between specific hazards and asthma were examined using logistic regression in high and low SVI groups (stratified by median percentile), and joint effects of mixture exposure were analyzed using quantile g-computation. ResultsResidential proximity to dry-cleaning solvent contamination was positively associated with asthma in the overall population. In the high SVI group, seven additional hazards--particularly air pollutants--were significantly linked to increased asthma odds (False discovery rate, FDR< 0.05). A quintile increase in the mixture exposure was associated with a 35% (95% CI: 6%, 73%) higher odds of asthma in the high SVI group, which was more pronounced than in the low SVI group (P for difference= 0.038). Key contributors included toluene, dry-cleaning sites, organic matter in PM2.5, and carbon monoxide, each accounting for over 10% of the mixture effect. Socioeconomic and housing/transportation-related vulnerabilities interacted with key hazards and mixture exposure on asthma (FDR interaction < 0.05). ConclusionResidents of high SVI neighborhoods are more vulnerable to environmental hazard-related asthma risks. Targeted interventions should prioritize communities with poor socioeconomic, housing, and transportation conditions to effectively mitigate these environmental health risks.