A new ECHO study found that although there is a correlation between childhood asthma and being born into a densely populated or lower-income neighborhood, Black and Hispanic children had consistently higher rates of asthma than White children, even in wealthier neighborhoods.
The study, led by ECHO investigators, Dr. Antonella Zanobetti, Harvard T.H Chan School of Public Health, Department of Environmental Health, and Dr. Patrick H. Ryan, Cincinnati Children’s Hospital Medical Center, included data from 5,809 children born over four decades throughout the United States, providing important insight into how racial and ethnic health inequities may cause children to develop wheezing – a symptom involving whistling breathing sounds due to narrowed airways – and asthma.
Of the 5,809 children studied, 46% reported wheezing prior to age 2 and 26% reported persistent wheeze through age 11. Diagnosis of asthma by age 11 varied by cohort, with an overall median prevalence of 25%. Children in neighborhoods with higher population density, and with more families with lower incomes and living below the poverty level, 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.
Researchers used questionnaires and interviews to collect information such as wheezing and asthma occurrence, medical history, and demographics from participating families over many years. Each child’s home address was matched to U.S. Census tract data for the decade closest to their birth year. Researchers examined the relationship between incidence of wheezing and asthma with children’s race and ethnicity, their mother’s education level and smoking habits, and socioeconomic conditions of the neighborhood in which they were born.
“Neighborhood- and individual-level characteristics and their root causes should be considered as sources of respiratory health inequities,” Dr. Zanobetti said. “Reducing these inequities requires identifying and repairing differences between and within neighborhoods to create equal access to healthy living conditions.”
This research, titled “Childhood Asthma Incidence, Early and Persistent Wheeze, and Neighborhood Socioeconomic Factors in the ECHO/CREW Consortium,” is published in JAMA Pediatrics.