This study was based on the research-supported understanding that the neighborhoods in which children live may play a critical role in explaining asthma disparities across populations. Asthma hospitalization and mortality rates are higher for African American children compared to white children; and children living in poverty are at a significantly higher asthma risk than children from more affluent families.
While race and family poverty are factors associated with the incidence of asthma in children, researchers have increasingly focused on neighborhood features which may trigger or worsen asthma symptoms. The aim of this study was to examine asthma prevalence in children and the social and structural conditions of neighborhoods in conjunction with demographic and familial characteristics to determine the relative importance of these determinants based on disparate neighborhood characteristics.
Data was obtained from the medical records of over 2000 children (age 2-12) living in Houston, Texas. In addition to asthma-related information, other data obtained from these records included information about child's age, gender, race/ethnicity, and family income. Family addresses were then linked to the social, economic, demographic, and air quality characteristics of the neighborhoods in which the children lived. Data analysis allowed the researchers to identify the relative risk of social, economic, and environmental risk factors for child asthma diagnoses.
Results indicated that the incidence of asthma differed significantly between neighborhoods, with children in disadvantaged neighborhoods having higher asthma diagnoses than children living in middle-class and advantaged neighborhoods. The low-income communities also had higher levels of ambient air pollutants than middle-class and advantaged neighborhoods. While this unequal exposure to air pollutants contributed to the asthma disparities, other socioeconomic and racial inequalities were also contributors, including certain protective factors enjoyed by non-Hispanic White children and children from affluent families. African American children across neighborhood types experienced a higher probability of asthma, but the more disadvantaged the neighborhood the larger the difference. These findings suggest that inequalities across communities create an environment where a child diagnosed with asthma in a disadvantaged neighborhood may be less able to buffer the harmful effects than children living in middle-class and higher-income neighborhoods.
Overall, this study found that the concentration of environmental exposures in disadvantaged communities increases the risk of asthma for children who already face many other health-related disadvantages. Social and racial inequalities, however, may be more than factors associated with asthma disparities in children; they may be major contributors.
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