Associations Between Perceptions of Community Safety With Respiratory Illness Among Low-Income Adults

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There is an association between an individual’s perceptions of community safety and adverse respiratory health among populations with exposure to high air pollution, according to new research.

Researchers recently explored the association between individual-level perception of community safety and respiratory illness among low-income minority adults who live in an area with routine poor air quality exacerbated by the emissions of a nearby freight railyard, and found that there is an association between an individual’s perceptions of community safety and adverse respiratory health among populations with exposure to high air pollution.

Previous evidence has suggested that social disadvantage often heightens the negative health effects of environmental hazards; however, there has been a limited amount of research into the perceptions of risk. The researchers collected interview-administered household surveys in English/Spanish from varying distances surrounding a freight railyard.

“Exposure to social stressors and environmental hazards are more common and are elevated in low-income, minority, urban communities,” noted the authors. “While it is well established that higher polluting industries are more likely to settle near low income communities (or that low income communities develop nearby due to lower housing costs), there is also growing evidence that suggests that social disadvantage (eg exposure to community violence) magnifies the effects from environmental hazards on adverse health outcomes.”


The study considered illness outcome as an affirmative response to doctor-diagnosed asthma, bronchial condition, emphysema, chronic obstructive pulmonary disease, or prescribed-inhaler usage. Additionally, respiratory symptoms outcome was an affirmative response to chronic cough, chronic mucus, or wheezing, while the independent variable was perceived community safety.

The results revealed that outcome prevalences were similar across environmental hazard regions, with 205 diagnosed-illness cases and 166 diagnosis-free participants reported symptoms. Of the total participants, 47.5% reported lack of perceived community safety, which was associated with environmental hazard regions.

“In conclusion, when living in a low-income community near a goods movement network with high exposure to diesel emission and in a region with routine poor air quality, the added psychosocial stressor of perceiving your residential community as unsafe increases the likelihood of having a doctor diagnosed chronic respiratory illness,” the authors stated.

Furthermore, when using multivariable log-binomial regression models adjusting for covariables, the researchers found that respiratory illness diagnosis was associated with lack of perceived community safety. Also, the sensitivity analyses showed a nonsignificant but increasing trend in the strength of association between safety perceptions and illness diagnosis with closer proximity to the railyard.

“Our finding further supports that when trying to elucidate the effect of air pollution on respiratory health, public health professionals, and policy makers must take into account a communities’ social, as well as environmental risk, context,” concluded the authors.


Arthur KN, Spencer-Hwang R, Knutsen SF, Shavlik D, Soret S, Montgomery S. Are perceptions of community safety associated with respiratory illness among a low-income, minority adult population? BMC Public Health. 2018;18:1089. doi: 10.1186/s12889-018-5933-4.