Racial, Social, and Environmental Risks for Childhood Asthma

Weitzman, Michael

doi:10.1001/archpedi.1990.02150350021016

Cited by 168 publications

(135 citation statements)

References 26 publications

(5 reference statements)

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“…Our study extends upon previous findings 11,12 providing evidence that in a cohort of urban youth, socioeconomic factors as well as selected characteristics of the immediate physical and broader social environment are associated with the diagnosis of asthma. While previous researchers have highlighted the fact that forces acting at the neighborhood level (e.g., markers of poverty including crime, vacant housing, and/or increased rental units) could be important contributors to childhood asthma, 3,11,[21][22][23][24][25][26] data from the current study shows that after adjustment for individual-level socioeconomic characteristics and/or directly observed housing and block conditions, all of the neighborhood level characteristics considered-except education level-were no longer significant. These results suggest that in many cases, neighborhood level associations may be able to be reduced to characteristics more proximal to the individual.…”

Section: Discussionmentioning

confidence: 99%

Individual, Housing, and Neighborhood Correlates of Asthma among Young Urban Children

2012

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Using data from a large cohort of urban children, this study identified multilevel correlates of asthma to determine whether neighborhood attributes remain associated with asthma after adjustment for individual level and immediate housing characteristics. A cross-sectional analysis was conducted using data from the Fragile Families and Child Well-being Study and its substudy, the In-Home Longitudinal Study of Pre-Schooled Age Children (n=1,784). The primary outcome was asthma diagnosis by age 5. Sociodemographic measures were assessed via telephone survey, housing and block conditions recorded via direct observation, and neighborhood characteristics came from geocoded census tract data. After multivariable adjustment, non-Hispanic Black, Puerto Rican, or other Hispanic race, child's lack of insurance coverage, male gender, presence of allergies, the exterior condition of a child's home, mother's educational attainment, and the percent of the neighborhood population with a bachelor's degree remained significantly associated with having received an asthma diagnosis by age 5. The authors identified sociodemographic and economic factors at the individual, household, and neighborhood level which are correlates of childhood asthma in urban areas. After adjustment for more proximal characteristics, the effects of all neighborhood markers were minimal, with the exception of neighborhood education.

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Section: Discussionmentioning

confidence: 99%

Individual, Housing, and Neighborhood Correlates of Asthma among Young Urban Children

2012

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“…The higher rate of asthma among Black compared with non-Black children in this age group may be the result of earlier asthma onset in Black children. 3 Some studies have concluded that demographic factors account for racial/ethnic differences in asthma prevalence. However, those analyses relied on a single income observation, which is not adequate to differentiate between long-term poor and nonpoor children.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Many clinical or area studies have reported substantially higher rates of asthma prevalence, [3][4][5] hospitalization, [6][7][8][9] and mortality among Black than White persons. 8,10,11 Because asthma is most common among low-socioeconomic status groups 12 and Black persons are more likely than White persons to be poor, 13 an important question is the extent to which racial/ethnic differences in asthma are due to poverty.…”

Section: Abstract Jane E Miller Phdmentioning

confidence: 99%

The effects of race/ethnicity and income on early childhood asthma prevalence and health care use

2000

Am J Public Health

171

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OBJECTIVES: Asthma is the most common chronic illness among US children and is most prevalent in low-income and minority groups. We used multivariate models to disentangle the effects of race/ethnicity, income, and other individual-level risk factors on asthma in a population-based sample of children aged 3 years. METHODS: Data are from the 1988 National Maternal and Infant Health Survey and 1991 Longitudinal Follow-Up. Odds ratios of asthma prevalence, hospitalization, and emergency room use were estimated, with control for socioeconomic characteristics, health behaviors, and insurance. RESULTS: Asthma prevalence, hospitalization, and emergency room use declined with increasing income for non-Black but not Black children. CONCLUSIONS: Lifetime income and sociodemographic characteristics do not explain the excess risks of asthma and emergency health care use for asthma among young Black children.

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“…[18][19][20] Other studies have found that when controlling for race, income, and/or residence in an urban setting, those disparities may diminish. [21][22][23] Nonetheless, the literature would suggest that morbidity is indeed higher among minority children. 21 In our study, children who were Hispanic and families that were Spanish-speaking were more likely to have had mild intermittent chronic disease, but those associations were not seen with the acute severity of asthma.…”

Section: Table 4 Location and Severity Characterization Of First Asthmentioning

confidence: 99%

The Effect of Acute and Chronic Asthma Severity on Pediatric Emergency Department Utilization

et al. 2006

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OBJECTIVE. Our goal was to teach emergency department (ED) physicians how to use standardized criteria for diagnosing and classifying asthma severity and to describe the patterns of pediatric ED utilization of these criteria for classification of both acute and chronic severity. METHOD.A health care provider education module was developed and implemented in 4 participating EDs in southeast Texas to educate ED physicians and health care providers on the diagnosis and acute and chronic severity classification of pediatric asthma patients. We undertook both retrospective (medical chart extraction) and prospective surveillance over a 2-year period of all children presenting to 1 of 4 EDs with acute asthma. Demographic characteristics, classification of severity, health care resource utilization, and primary physician contact information were collected.RESULTS. The health care provider educational intervention was provided for 84 different physicians. A subset of 16 physicians was randomly tested preintervention and postintervention. Mean mock-scenario scores at 2 weeks showed an improvement of 55.6%, which was sustained at retesting at 6 months. Over the 2-year period, 6222 individual pediatric ED encounters were entered into the surveillance database. The median age of presentation was 5 years. More than 32% of the patients in the study were uninsured. The majority of the patients in each category had asthma of mild severity: mild intermittent chronic (58.7%) and mild acute (53.9%).CONCLUSIONS. Physicians who completed a health care provider education module learned to effectively diagnose asthma and recognize standardized acute and chronic severity classifications. The majority of children with asthma who presented to the Texas Emergency Department Asthma Surveillance project's participating EDs were classified as having mild acute severity and mild intermittent chronic disease. Almost one third of these patients did not have health insurance.

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Racial, Social, and Environmental Risks for Childhood Asthma

Cited by 168 publications

References 26 publications

Individual, Housing, and Neighborhood Correlates of Asthma among Young Urban Children

Individual, Housing, and Neighborhood Correlates of Asthma among Young Urban Children

The effects of race/ethnicity and income on early childhood asthma prevalence and health care use

The Effect of Acute and Chronic Asthma Severity on Pediatric Emergency Department Utilization

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