Neighborhood-Level Factors Related to Asthma in Children Living in Urban Areas

Abstract

Asthma disproportionately affects children who are non-White and of low socioeconomic status. One innovative approach to address these health disparities is to investigate the child’s neighborhood environment and factors influencing asthma symptoms. The purpose of this integrative review is to critique research investigating the relationships between neighborhood-level factors and asthma morbidity in urban children. Three literature databases were searched using the terms “asthma,” “child,” “neighborhood,” and “urban.” The articles included were organized into six themes within the larger domains of prevalence, physical, and social factors. Literature tables provide in-depth analysis of each article and demonstrate a need for strengthening analysis methods. The current research points to the necessity for a multilevel study to analyze neighborhood-level factors that are associated with increased asthma morbidity in urban children. School nurse clinicians, working within children’s neighborhoods, are uniquely positioned to assess modifiable neighborhood-level determinants of health in caring for children with asthma.

Asthma Surveillance — United States, 2006–2018

“…Barriers to health care access can result in unmet health care needs and preventable hospitalizations (19). Among inner-city residents, risk factors for developing asthma and experiencing asthma exacerbations include mold or mildew in homes (20), air pollution, lack of access to health care, and exposure to secondhand smoke (21). In contrast, suburban residents have been shown to have the best health outcomes (8).…”

Effects of particulate matter (PM) on childhood asthma exacerbation and control in Xiamen, China

“…Most of the studies conducted worldwide addressed the relationship between PM exposure and asthma in terms of long-term effects and few assessed the impact of PM exposure on asthma control rate [17]. Many studies address the transient effect of indoor and ambient pollutants and allergens on asthma exacerbation but less is known for particulate matters [18, 19]. On the other hand, current empirical studies examining the toxic effects of PM exposure were mostly conducted in cell lines and mouse models based on case-control design.…”

Child Poverty, Toxic Stress, and Social Determinants of Health: Screening and Care Coordination

“…Professional organizations, such as the Public Health Nursing section of the American Public Health Association, advocate for the Environmental Protection Agency’s “Clean Power Plan,” which reduces carbon emissions and other harmful air pollutants (The American Public Health Association, 2017). Nurse researchers analyze the contributions of SDOH to respiratory illness (DePriest & Butz, 2017) and also test interventions (Butz et al, 2017) to decrease asthma morbidity.…”