Study investigates how neighborhood and race/ethnicity play a role in asthma

New research has revealed that neighborhood characteristics at birth and race/ethnicity inequities may play a role in the development of asthma.

The study, published in the journal JAMA Pediatrics, was part of a multi-institutional collaboration and analyzed data from 5,809 children born over a span of four decades from 10 different study sites throughout the United States. The study sought to answer the question – “Is there an association between neighborhood characteristics at birth, race, and ethnicity, and the risk for developing childhood wheeze and asthma?”

Researchers found that children born in areas with higher population density and greater proportion of low-income households and poverty had higher hazard ratios of asthma incidence. In addition, they found that Black and Hispanic children were at significantly higher risk for developing asthma than white children and they remained at increased risk for asthma when risk was examined for asthma across neighborhoods of all income levels.

“Our results emphasize that solving health inequities requires not just individual-level changes in practice, but also large-scale changes in policy and practice to improve the respiratory health of populations at the neighborhood, regional, and national level,” said senior author Diane Gold, MD, of the Channing Division of Network Medicine at Brigham and Women’s Hospital in a statement. “Housing conditions, environmental exposures, and access to care are all likely contributors to our findings. But in addition to these, racism, both at the individual and institutional level, may also contribute to environmental injustice and health inequities.”

Using questionnaires and interviews at each study site to collect information such as wheezing and asthma occurrence, medical history, and demographics from children and their parents over many years, each child’s home address was matched to U.S. Census tract data for the decade closest to the birth year. Using survival analysis and the responses via questionnaire, they examined how children’s race/ethnicity and their mother’s education level and smoking habits, in combination with their neighborhood conditions, were related to children’s incidence of asthma and wheeze.

The study’s results found that of the 5,809 children, 46 percent experienced wheezing in their first year of life, with 26 percent having wheezing through age 11. One in four children were diagnosed with asthma by age 11. Children in neighborhoods with higher population density and more families with low income and below the poverty level also experienced more asthma and early and persistent wheezing. Black and Hispanic children remained at higher risk for asthma than white children, even in neighborhoods with more resources.

This research was supported by a United States Department of Health and Human Services National Institutes of Health (NIH) grant.