Study Shows Association Between Better Neighborhood Conditions and Lower Childhood Asthma Rates

Posted on August 28, 2023August 27, 2025 by Jodi Snare

FOR IMMEDIATE RELEASE

Living in a neighborhood with better access to resources such as high-quality housing, healthy food, parks and playgrounds, and clean air during the early stages of childhood was associated with lower asthma incidence in a new study from NIH’s Environmental influences on Child Health Outcomes (ECHO) Program.

Children born in high-opportunity neighborhoods had an asthma incidence rate of 23.3 cases per 1,000 children, while those born in very low and low-opportunity neighborhoods had rates of 35.3 per 1,000 and 27 per 1,000, respectively.

“Understanding neighborhood conditions could help researchers identify vulnerable children who are at high risk for developing asthma,” said study author Izzuddin Aris, PhD, of Harvard Medical School. “This information can also inform efforts by policymakers, researchers, and community groups to improve children's health and foster equity across neighborhoods.”

Researchers in this study measured neighborhood conditions using the Child Opportunity Index and the Social Vulnerability Index, which link residential addresses at birth, infancy (age 0.5‒1.5 years), and early childhood (age 2.0‒4.8 years) to census-tract data about the opportunities and resources available in the surrounding neighborhood. Only the Child Opportunity Index, which measures neighborhood resources and conditions deemed essential for healthy child development, showed significant associations with childhood asthma incidence. The Social Vulnerability Index measures factors that make a community more vulnerable in the aftermath of natural or human-caused disasters.

This study used data from 10,516 children at 46 research sites participating in ECHO, each having at least one residential address from birth and a parent or caregiver report of a physician’s diagnosis of asthma. These differences in the incidence of asthma persisted even after controlling for sociodemographic characteristics, parental asthma history, and the number of births a mother had.

“These findings emphasize the importance of investigating whether investing in early-life health and environmental or social and economic resources can promote health equity in pediatric asthma,” said Dr. Aris.

Dr. Aris led this collaborative research published in JAMA Pediatrics. An embargoed copy of the study is available upon request.

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About ECHO:

Launched in 2016, the Environmental influences on Child Health Outcomes (ECHO) Program is a research program in the Office of the Director at the NIH with the mission to enhance the health of children for generations to come. ECHO investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

About the NIH: NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, visit www.nih.gov.

Media Contacts

For information or to request an interview, contact Rebekah Yeager, rebekah.yeager@nih.gov.

If you are not a member of the media, but have a general inquiry, please contact NIHKidsandEnvironment@od.nih.gov.

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Check out the recent issues of our bi-monthly newsletter, the ECHO Connector, for program news and the latest research findings.

To receive the ECHO Connector through email, subscribe here.

Follow @ECHOChildHealth for the latest ECHO Program updates on Twitter.

Can Neighborhood Conditions Throughout Childhood Shape the Risk of Developing Asthma?

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ECHO Study Suggests Neighborhood Conditions Throughout Childhood May Shape Risk of Developing Asthma

Authors: Izzuddin Aris, et al.

Who sponsored this study?

The Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health supported this research.

Why was this study needed?

Neighborhood conditions, such as access to housing, healthy food, transportation, and education centers, can contribute to the development of childhood asthma. Researchers often measure these conditions using the Child Opportunity Index and the Social Vulnerability Index, which link residential addresses at birth, infancy (age 0.5‒1.5 years), and early childhood (age 2.0‒4.8 years) to census-tract data about the opportunities and resources available in the surrounding neighborhood. Previous studies looking into this topic lacked geographic diversity or considered only specific socioeconomic aspects of neighborhood disadvantage, which may not fully capture the role of early-life experiences on health outcomes. This study examines the association of conditions and resources available in neighborhoods during different developmental stages with childhood asthma incidence.

What were the study results?

Living in a neighborhood with higher opportunity at birth, infancy, or early childhood was associated with lower asthma incidence when compared to living in a neighborhood with lower opportunity. Differences in sociodemographic characteristics, parental asthma history, or the number of births a mother had did not explain this effect.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the impact?

Neighborhood conditions could help researchers identify vulnerable children who are at high risk for developing asthma. Policymakers, researchers, and community groups can use this information to guide decisions and interventions to improve the health of children and promote equitable opportunities across neighborhoods.

Who was involved?

This study used data from 10,516 children at 46 research sites participating in ECHO. The participants have at least one residential address from birth and a parent or caregiver report of a physician’s diagnosis of asthma.

What happened during the study?

Researchers linked participants’ residential addresses to the Child Opportunity Index and Social Vulnerability Index. They estimated asthma incidence rates associated with Child Opportunity Index or Social Vulnerability Index data for a child’s neighborhood at each life stage, adjusting for sociodemographic characteristics, maternal and paternal history of asthma, and the number of births a mother had.

What happens next?

Future studies can explore the impact of investing in early life health and environmental, social, and economic resources on improving health outcomes for children in disadvantaged neighborhoods. Follow-up studies can also focus on how these neighborhood-level factors are affecting asthma rates and how moving may alter asthma development.

Where can I learn more?

Access the full journal article, titled “Associations of Neighborhood Opportunity and Vulnerability with Incident Asthma Among U.S. Children in the ECHO cohorts,” in JAMA Pediatrics.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published August 28, 2023

Access the associated article.

Download this summary

ECHO Study Suggests Neighborhood Conditions Throughout Childhood May Shape Risk of Developing Asthma

ECHO Researchers Investigate Link Between Neighborhood Conditions During Childhood and Asthma Incidence

Posted on August 28, 2023August 28, 2023 by Jodi Snare

Collaborative ECHO research led by Izzuddin Aris, PhD, of Harvard Medical School examined the association of conditions and resources available in neighborhoods during different development stages with childhood asthma incidence.

Neighborhood conditions, such as access to housing, healthy food, transportation, and education centers, can influence the development of childhood asthma. Researchers often measure these conditions using the Child Opportunity Index and the Social Vulnerability Index, which link residential addresses at birth, infancy (age 0.5‒1.5 years), and early childhood (age 2.0‒4.8 years) to census-tract data about the opportunities and resources available in the surrounding neighborhood.

ECHO researchers used data from 10,516 children at 46 research sites participating in the ECHO Program. The participants had at least one residential address from birth and a parent or caregiver report of a physician’s diagnosis of asthma.

Children born in high-opportunity neighborhoods had an asthma incidence rate of 23.3 cases per 1,000 children, while those born in very low and low-opportunity neighborhoods had rates of 35.3 per 1,000 and 27 per 1,000, respectively.

“Neighborhood conditions could help researchers identify vulnerable children who are at high risk for developing asthma,” said Dr. Aris. “This information can also guide policymakers, researchers, and community groups to improve children’s health and foster equity across neighborhoods.”

Future studies can explore the impact of investing in early life health and environmental, social, and economic resources on improving health outcomes for children in disadvantaged neighborhoods. Follow-up studies can also focus on how these neighborhood-level factors are affecting asthma rates and how moving may alter asthma development.

This research, titled “Associations of Neighborhood Opportunity and Vulnerability with Incident Asthma Among U.S. Children in the ECHO cohorts,” is published in JAMA Pediatrics.

Read the research summary.

Specific Social, Environmental Factors May Influence Incidence Rates of Childhood Asthma with Recurrent Exacerbations

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Specific Social, Environmental Factors May Influence Incidence Rates of Childhood Asthma with Recurrent Exacerbations

Authors: Rachel L. Miller; Christine C. Johnson, et al.

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) Program, Office of The Director, National Institutes of Health.

Why was this study needed?

While the prevalence of asthma has been reported widely in the United States and elsewhere, studies on childhood asthma incidence rates within specific populations and across various types of asthma and age ranges have been relatively sparse. Describing the incidence rates of ARE across various pediatric populations is a critical first step for identifying potential risk factors and causes.

What were the study results?

In this study, investigators wanted to gather more information about factors that influence the rates of childhood asthma with recurrent exacerbations (ARE)—a subtype of asthma where children experience frequent, severe episodes of asthma.

ARE incidence rates were highest among children ages 2-4 years old, and among non-Hispanic Black and Hispanic Black children. ARE rates were also higher among children living in the Northeast and Midwest compared to those living in the West. Children with a parental history of asthma had ARE rates 2.9 times greater compared to those with no parental history.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the impact?

Higher incidence rates of ARE among young children, non-Hispanic Black and Hispanic Black children, and children living in the Northeast and Midwest suggest that differential environmental exposures may play a significant role in the onset of recurring asthma issues in children. ARE rates are consistently higher among children with a parental history of asthma, especially for young children, which may be due to a combination of genetic, environmental, and family lifestyle factors.

Who was involved?

The research team leveraged data from 17,246 children born between 1990 and 2017 who were enrolled in 60 ECHO research sites in the U.S. and Puerto Rico. Child participants or their caregivers reported whether and when the child had an asthma diagnosis and any oral corticosteroids prescribed from a health care provider. Incidence rates of ARE were based on reports of systemic (not inhaled) corticosteroid use.

Of the 4,114 children diagnosed with asthma during this study, there were 2,061 children with at least one asthma episode when they used oral steroid medication; 734 of these children had 2 or more asthma episodes with steroid medication use and met the conditions for ARE.

What happened during the study?

The researchers calculated the incidence rates of ARE for the study population as a whole, along with the rates for subsets of the population defined by the year of ARE diagnosis, the decade they were born, their age and sex, their race and ethnicity, their residence at birth, and their parents’ history of asthma. The researchers followed the children from birth until they developed ARE, reached the age of 20 years or the study period ended. The study identified children who developed ARE based on at least two reports of systemic steroid medication use at any time during the entire follow-up period. Children who received asthma diagnoses before age 5 years were required to have confirmation after 5 years, either by a parent or caregiver, adolescent self-report of asthma symptoms, hospitalization, emergency department or urgent care visit for asthma, provider visits due to asthma, or asthma medication use.

What happens next?

ECHO researchers are planning new studies that examine key early environmental exposures that could contribute to ARE, including viral respiratory tract infections, indoor allergens, environmental tobacco smoke, air pollution, stress, socioeconomic status, and where children live.

Where can I learn more?

Access the full journal article, titled “Incidence Rates of Childhood Asthma with Recurrent Exacerbations in the U.S. Environmental influences on Child Health Outcomes (ECHO) Program,” in The Journal of Allergy and Clinical Immunology.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published March 25, 2023

Access the associated article.

Download this summary

Specific Social, Environmental Factors May Influence Incidence Rates of Childhood Asthma with Recurrent Exacerbations

ECHO Researchers Examine Incidence Rates for Childhood Asthma With Recurrent Exacerbations and Suggest Possible Social and Environmental Risk Factors

Posted on May 10, 2023December 4, 2023 by Jodi Snare

Collaborative ECHO research led by Rachel L. Miller, MD of Icahn School of Medicine at Mount Sinai and Christine C. Johnson, PhD, MPH of Henry Ford Health System investigates the factors that influence the rates of childhood asthma with recurrent exacerbations (ARE)—a subtype of asthma where children experience frequent, severe episodes of asthma. The researchers leveraged data from over 17,000 children born between 1990 and 2017 and found that children ages 2-4 years old, non-Hispanic Black and Hispanic Black children, and children who lived in the Northeast and Midwest had the highest incidence rates of ARE. Additionally, children with a parental history of asthma had ARE rates almost 3 times greater compared to those with no parental history. This research, titled “Incidence Rates of Childhood Asthma with Recurrent Exacerbations in the U.S. Environmental influences on Child Health Outcomes (ECHO) Program,” is published in The Journal of Allergy and Child Immunology.

While the prevalence of asthma has been reported widely in the United States and elsewhere, studies on childhood asthma incidence rates within specific populations and across various types of asthma and age ranges have been limited. “Describing the incidence rates of ARE across a large, diverse population of children is a critical first step for identifying potential risk factors and causes,” explained Dr. Johnson.

To conduct this research, the research team leveraged data from children enrolled in 60 ECHO cohorts across the U.S. and Puerto Rico. Child participants or their caregivers reported whether and when the child had an asthma diagnosis and any corticosteroids prescribed over time from their health care providers. Recurrent exacerbations of asthma were based on reports of systemic (not inhaled) corticosteroid use. The researchers calculated incidence rates of ARE for the study population overall, along with rates for subsets of the population defined by the years the ARE were diagnosed, the decade children were born, their age and sex, their race and ethnicity, their residence at birth, and their parents’ history of asthma.

“While children with ARE are all different, these findings suggest that we should examine in the future key elements of the early environment, including viral respiratory tract infections, indoor allergens, environmental tobacco smoke, air pollution, stress, and socioeconomic status, which could contribute to ARE,” said Dr. Miller. “Understanding these causes will help researchers determine how to best prevent ARE and associated asthma outcomes.”

Read the research summary.

NIH Study Investigates Factors Affecting Asthma With Frequent Symptom Flare Ups in Young Children

Posted on May 10, 2023August 27, 2025 by Jodi Snare

FOR IMMEDIATE RELEASE

Young children, ages 2 to 4 years, especially those with parental history of asthma, suffered the highest rates of asthma with recurrent exacerbations (ARE) over a nearly 30-year period studied in new research funded by the Environmental influences on Child Health Outcomes Program (ECHO) at the National Institutes of Health.

“Describing the incidence rates of ARE across a large, diverse population of children is a critical first step for identifying potential risk factors and causes,” explained Christine Johnson, PhD, MPH, an ECHO Program investigator at Henry Ford Health.

During this study, ECHO researchers looked at data from over 17,000 children between 1990 and 2017 from across the U.S. including Puerto Rico in order to learn which factors influenced the rates of childhood ARE—a subtype of asthma where children experience frequent, severe episodes of asthma. They found that non-Hispanic Black and Hispanic Black children, children ages 2 to 4 years old, and children who lived in the Northeast and Midwest had the highest rates of ARE.

These findings suggest that different environmental and social factors may play a significant role in the onset of recurring asthma issues in children.

“Understanding these causes will help researchers determine how to best prevent ARE and associated asthma outcomes,” said Rachel L. Miller, MD, an ECHO Program investigator at the Icahn School of Medicine at Mount Sinai.

Drs. Miller and Johnson led this collaborative research published in the Journal of Allergy and Clinical Immunology.

Miller, R. et al. Incidence Rates of Childhood Asthma with Recurrent Exacerbations in the U.S. Environmental influences on Child Health Outcomes (ECHO) Program. DOI: 10.1016/j.jaci.2023.03.016

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About ECHO: ECHO is a nationwide research program supported by the NIH. Launched in 2016, ECHO aims to enhance the health of children for generations to come. ECHO investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

About the NIH: NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, visit www.nih.gov.

Media Contacts

For information or to request an interview, contact Rebekah Yeager, rebekah.yeager@nih.gov.

If you are not a member of the media, but have a general inquiry, please contact NIHKidsandEnvironment@od.nih.gov.

Connect With Us

Check out the recent issues of our bi-monthly newsletter, the ECHO Connector, for program news and the latest research findings.

To receive the ECHO Connector through email, subscribe here.

Follow @ECHOChildHealth for the latest ECHO Program updates on Twitter.

NIH Study Suggests Association Between Mothers’ Experiences of Maltreatment in Their Own Childhood to Their Children’s Health Outcomes

Posted on February 24, 2023August 27, 2025 by Jodi Snare

FOR IMMEDIATE RELEASE

Children of mothers who experienced childhood abuse or neglect may have a higher risk for developing asthma, ADHD, autism spectrum disorder, and certain mental health issues, according to a study funded by the Environmental influences on Child Health Outcomes Program (ECHO) at the National Institutes of Health.

This research suggests that a mother’s history of being abused or neglected as a child may increase their child’s risk for developing one or more of these health outcomes at once. Daughters of these mothers may also be more likely to develop obesity, the study found, as compared to sons.

“Asking parents about their childhood experiences during prenatal and pediatric care, identifying parents with a history of childhood abuse or neglect, and offering counseling and support to those parents could help improve health outcomes for their children,” said Claudia Buss, PhD, an ECHO Program investigator at the University of California, Irvine and Charité - Universitätsmedizin Berlin.

The researchers surveyed 4,337 mothers from 21 ECHO cohorts across the U.S. on their childhood experiences. About 44 percent of these mothers reported childhood abuse or neglect. The researchers also collected data on the rates of diagnosis for a number of physical and mental conditions among the children of mothers participating in the study.

Dr. Buss and Nora K. Moog, PhD of Charité - Universitätsmedizin Berlin led this collaborative research published in The Lancet Public Health.

Buss, C. et al. Intergenerational transmission of the consequences of maternal exposure to childhood maltreatment – a United States nationwide observational study of multiple cohorts in the ECHO program. The Lancet Public Health. DOI: 10.1016/S2468-2667(23)00025-7

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About ECHO: ECHO is a nationwide research program supported by the NIH. Launched in 2016, ECHO aims to enhance the health of children for generations to come. ECHO investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

About the NIH: NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, visit www.nih.gov.

Media Contacts

For information or to request an interview, contact Rebekah Yeager, rebekah.yeager@nih.gov.

If you are not a member of the media, but have a general inquiry, please contact NIHKidsandEnvironment@od.nih.gov.

Connect With Us

Check out the recent issues of our bi-monthly newsletter, the ECHO Connector, for program news and the latest research findings.

To receive the ECHO Connector through email, subscribe here.

Follow @ECHOChildHealth for the latest ECHO Program updates on Twitter.

ECHO Study Suggests Link Between Severe Bronchiolitis During Infancy and Asthma During Childhood

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ECHO Study Suggests Link Between Severe Bronchiolitis During Infancy and Asthma During Childhood

Author(s): Kohei Hasegawa, et al.

Who sponsored this study?

The Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health supported this research.

What were the study results?

Bronchiolitis is a wheezing illness usually caused by a lung infection such as Respiratory Syncytial Virus (RSV). During this study, researchers found that the hospitalized infants with bronchiolitis were more likely to develop asthma by the age of 12 years when compared to hospitalized infant without bronchiolitis. The researchers also saw that this effect was stronger for non-Hispanic White and non-Hispanic Black infants, compared with Hispanic infants.

What was the study's impact?

This is the first nationwide investigation that demonstrates the role of severe bronchiolitis during infancy on influencing long-term childhood asthma risk and identifies subgroups of children who are most at risk for developing asthma following bronchiolitis during infancy. These results could help future investigations to identify what factors may influence the association between severe bronchiolitis and childhood asthma risk across different demographic groups, which could advance the development of targeted prevention strategies for childhood asthma.

Why was this study needed?

Severe bronchiolitis is the most common reason for hospitalization in U.S. infants younger than 2 years old. Many studies have shown that severe bronchiolitis, requiring hospitalization during infancy, is a risk factor for developing childhood asthma. However, these studies have been too narrow to evaluate how severe bronchiolitis during infancy affects childhood asthma risk in various demographic subgroups.

Who was involved?

The researchers analyzed data from 11,762 infants enrolled in 53 ECHO research sites across the United States. All of these infants were hospitalized at age 12 months or younger between 2001-2021. Of these infants, 10% were hospitalized with bronchiolitis. One of the participating ECHO cohorts selectively enrolled children with a parental history of asthma.

What happened during the study?

The researchers collected data from participating infants under 12 months old on caregiver-reported hospitalization for bronchiolitis. The researchers then used data on caregiver-reported asthma diagnosis prior to age 12 to evaluate the relationship between severe bronchiolitis and childhood asthma to determine how this relationship may be affected by major demographic and clinical factors.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What happens next?

Future studies are needed to investigate the reasons underlying the links among infant bronchiolitis, demographic and clinical factors, and the development of asthma. These findings not only provide an evidence base for early identification of children who are at high risk for asthma but also offer opportunities for early preventive interventions in this large, high-risk population.

Where can I learn more?

Access the full journal article, titled “Association of Severe Bronchiolitis during Infancy with Childhood Asthma Development: An Analysis of the ECHO Consortium,” in Biomedicines.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published: December 22, 2022

Download this summary

ECHO Study Suggests Link Between Severe Bronchiolitis During Infancy and Asthma During Childhood

ECHO-funded Research Finds Higher Asthma Rates Among Black and Hispanic Children Regardless of Neighborhood Income or Density

Posted on June 2, 2022December 5, 2023 by Jodi Snare

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.

Read the Research Summary.

ECHO Study Links Poor Neighborhood Conditions With Higher Risk of Asthma in Children

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ECHO Study Links Poor Neighborhood Conditions With Higher Risk of Asthma in Children

Author(s): Antonella Zanobetti, Patrick H. Ryan, et al

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program, Office of The Director, National Institutes of Health.

What were the study results?

Of the 5,809 children studied, 46% experienced wheezing in their first year of life, with 26% having wheezing through age 11. Diagnosis of asthma by age 11 varied by cohort, with an overall median prevalence of 25%. Children in neighborhoods with more people, and with more families with lower incomes, experienced more asthma and early and persistent wheezing. Black and Hispanic children remained at higher risk for asthma than White children, even in wealthier neighborhoods.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the study's impact?

This study suggests that neighborhood characteristics at birth and race/ethnicity play a role in the development of childhood wheezing and asthma. This information can help inform strategies to reduce childhood asthma, including strategies that address the socioeconomic factors that create higher risks for Black and Hispanic children.

Why was this study needed?

In the United States, Black and Hispanic children have higher rates of asthma compared to White children and more often live in communities where households struggle to meet their basic needs. The objective of this study was to explore how much neighborhood-level socioeconomic factors, like income and education, contribute to differences in childhood wheezing and asthma between Black, White, and Hispanic children.

Who was involved?

Almost 6,000 children across the United States born between the 1980s and 2010s.

What happened during the study?

The team used questionnaires and interviews to collect information such as wheezing and asthma occurrence, medical history, and demographics. Each child’s home address was matched to U.S. Census data for the decade closest to their birth year. Researchers studied how children’s race/ethnicity and their mother’s education level and smoking habits, plus their neighborhood socioeconomic conditions, were related to wheezing – a symptom involving whistling breathing sounds due to narrowed airways – and asthma.

Where can I learn more?

Access the full journal article, titled “Childhood Asthma Incidence, Early and Persistent Wheeze, and Neighborhood Socioeconomic Factors in the ECHO/CREW Consortium” in JAMA Pediatrics.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published May 23, 2022

Read the associated article.

Download this summary

ECHO Study Links Poor Neighborhood Conditions With Higher Risk of Asthma in Children

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ECHO Study Suggests Neighborhood Conditions Throughout Childhood May Shape Risk of Developing Asthma

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Specific Social, Environmental Factors May Influence Incidence Rates of Childhood Asthma with Recurrent Exacerbations

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ECHO Study Suggests Link Between Severe Bronchiolitis During Infancy and Asthma During Childhood

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ECHO Study Links Poor Neighborhood Conditions With Higher Risk of Asthma in Children

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