Longitudinal associations between neighbourhood walkability and incident childhood asthma
Notice bibliographique
Résumé
Low neighbourhood walkability has been associated with chronic conditions such as obesity and diabetes, but the relationship between neighbourhood walkability and incident childhood asthma has not been determined. We evaluated the association between neighbourhood walkability and incident childhood asthma using prospectively-collected administrative data at the Institute for Clinical Evaluative Sciences. Among the 1997-2003 birth cohorts of children living in Toronto, neighbourhood quintile of walkability was reported using a validated walkability index with 4 dimensions: population density, dwelling density, access to services and street connectivity. Incident asthma was defined by the time of entry into the Ontario Asthma Surveillance Information System (OASIS) database, requiring 2 outpatient visits for asthma within 2 consecutive years or any hospitalization for asthma. Sex and neighbourhood income quintile were obtained from the Registered Person’s Database. Histories of preterm delivery, obesity and other atopic conditions were obtained from Ontario Health Insurance Plan records. We calculated the associations between incident childhood asthma and the two lowest versus the two highest neighbourhood walkability quintiles using Cox proportional and discrete-time hazard models. Twenty-one percent of the 326 383 children met the OASIS criteria for asthma. After adjusting for sex, preterm delivery, obesity, atopic conditions and neighbourhood income quintile, children with low home neighbourhood walkability at birth were at increased risk of asthma development [hazard ratio (HR) 1.11; 95% confidence interval (CI), 1.08-1.14], and the association did not change for children with healthcare visits for asthma in the past year (HR 1.10; 95% CI, 1.04-1.16). When walkability in each year of the child’s life was considered, low neighbourhood walkability was associated with increased odds of incident childhood asthma (odds ratio 1.12; 95% CI, 1.09-1.15). These associations were not substantially affected by year of birth within the cohort. Children living in neighbourhoods with low walkability are at increased risk of incident childhood asthma after adjusting for neighbourhood and individual characteristics. The association persists for children with visits for asthma within the past year. Possible mechanisms of this association include more physical activity, fewer weight problems and decreased exposure to traffic-related air pollution in more walkable neighbourhoods. Our findings suggest that promotion of neighbourhood walkability may offer a strategy for primary asthma prevention. Walkability of existing neighbourhoods may be improved by encouraging greater placement of services such as banks and grocery stores within walking distance of residential neighbourhoods and adding pedestrian paths between roads to improve street connectivity.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».