health disparities

Living in Low-income-low-food-access Neighborhoods Linked to Higher Risk of Childhood Asthma

Posted on by Jodi Snare

Living in a low-income neighborhood with low food access was associated with higher risks of developing asthma, according to a recent ECHO Cohort study led by Veronica A. Wang, PhD, Antonella Zanobetti, PhD, and Diane Gold, MD of Harvard T. H. Chan School of Public Health and Rima Habre, ScD of the University of Southern California.

Asthma is characterized by chronic inflammation in the lungs, and prior research shows that a nutritious diet can reduce airway inflammation. However, access to affordable and healthy foods is often difficult for many communities that have limited access to supermarkets or grocery stores. In this study, the researchers wanted to learn whether living in a low-income-low-food access neighborhood was associated with childhood asthma and whether this association was modified by sociodemographic factors.

The study included 16,012 children from 35 ECHO Cohort study sites across the U.S., and the investigators used low-income-low-food-access (LILA) neighborhood metrics from the U.S. Department of Agriculture’s Food Access Research Atlas to evaluate each child’s neighborhood food access.

Key Takeaways include:

  • Living in a low-income neighborhood with low food access was associated with higher risks of developing asthma for both cumulative early (age 0-5 years) and cumulative middle (age 0-11 years) childhood, which stronger associations observed for cumulative early childhood.
  • The increased risk of asthma was more noticeable among girls, Hispanic children, and children whose mothers had less than a high school education.
  • The findings suggest that food access in the immediate vicinity of residence and that vehicle access may be important and may contribute to disparities in childhood asthma development.

This collaborative research, titled “Residing in a low-income-low-food-access neighbourhood and asthma in early and middle childhood in the Environmental influences on Child Health Outcomes (ECHO) program: a multisite cohort study,” is published in BMJ Open.

Children Living in Low-income Neighborhoods with Low Food Access at Higher Risk of Developing Asthma, ECHO Study Finds

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Children Living in Low-income Neighborhoods with Low Food Access at Higher Risk of Developing Asthma, ECHO Study Finds

Authors: Veronica Wang, Antonella Zanobetti, Diane Gold, Rima Habre, 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?

Asthma is characterized by chronic inflammation in the lungs, and prior research shows that a nutritious diet can reduce airway inflammation. However, access to affordable and healthy foods is often difficult for many communities that have limited access to supermarkets or grocery stores. In this study, the researchers wanted to learn whether residing in a low-income-low-food access neighborhood was associated with childhood asthma and whether this association was modified by sociodemographic factors.

 

What were the study results?

This study found that living in a low-income neighborhood with low food access was associated with higher risks of developing asthma in both cumulative early (age 0-5 years) and cumulative middle (age 0-11 years) childhood, with stronger associations observed in cumulative early childhood. The increased risk of asthma was more prominent among girls, Hispanic children, and children whose mothers had less than a high school education.

 

What was the study's impact?

This study demonstrates the importance of the neighborhood food environment to children’s respiratory health, particularly in early childhood. The findings suggest that food access in the immediate vicinity of residence and that vehicle access may be important and may contribute to disparities in childhood asthma development.

 

Who was involved?

The study included 16,012 children from 35 ECHO Cohort study sites, born between 1998 and 2021, from across the United States.

 

What happened during the study?

During the study, researchers collected information on participants’ residential addresses and whether they were diagnosed with asthma in cumulative early childhood (by age 5) or middle childhood (by age 11). Using the U.S. Department of Agriculture’s Food Access Research Atlas, the researchers evaluated whether each child lived in a low-income neighborhood that was within 0.5-1 mile of a supermarket (for urban areas) or 10-20 miles (for rural areas). They also evaluated whether each child lived in a low-income area where more than 100 households do not have a vehicle or a nearby supermarket. Using this data, researchers looked at how living in a low-income-low-food-access neighborhood might affect childhood asthma incidence. They also took into account factors like the child's sex, race/ethnicity, mother's education, whether the mother smoked during pregnancy, and whether the parents had asthma.

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?

Additional studies could help researchers better understand how community access to healthy, nutritious foods affects asthma development. Future studies could also consider how other influences, such as the affordability of healthy foods and school-based food programs, might influence child health outcomes.

 

Where can I learn more?

Access the full journal article, titled “Residing in a low-income-low-food-access neighbourhood and asthma in early and middle childhood in the Environmental influences on Child Health Outcomes (ECHO) program: a multisite cohort study,” in BMJ Open.

 

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

Published June 30, 2025

 

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Children Living in Low-income Neighborhoods with Low Food Access at Higher Risk of Developing Asthma, ECHO Study Finds

 

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NIH Study Highlights Potential Disparities in Birthweight Outcomes Linked to Environmental Exposures in Vulnerable Populations

Posted on by Jodi Snare

A new study from the Environmental influences on Child Health Outcomes (ECHO) Program sheds light on how environmental exposures may have a larger impact on birth outcomes in vulnerable populations, particularly those defined by race, ethnicity, and maternal education. Researchers wanted to understand when the effect of these exposures becomes clinically significant and how different levels of exposure impact various groups differently.

To explore this, researchers used statistical models to simulate four potential scenarios in which average birthweights in a population could be reduced by varying amounts: 50g, 125g, 167g, and 250g. The study found that the percentage of children with low birthweight (LBW) (birthweight<2500g) varied by socioeconomic categories with the greatest percentage LBW seen in the most vulnerable socioeconomic groups. After analyzing the four scenarios, a clear trend was seen such that the greatest impact of an exposure was seen in the most vulnerable sub-populations. This trend was observed for all scenarios including the impact of a small environmental exposure. The most striking disparity among all scenarios was found in racial sub-populations.

This study showed how vulnerable groups, who already face higher risks of poor health, are more affected by small environmental exposures compared to the general population. Read a research summary here.

Vulnerable Populations More Likely to be Impacted by Small Environmental Effects, ECHO Study Finds

Vulnerable Populations More Likely to be Impacted by Small Environmental Effects, ECHO Study Finds

Authors: Janet L. Peacock, 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?

A challenge in public health is determining when the effect of an environmental exposure is large enough to be clinically important. Vulnerable populations—defined by sociodemographic factors such as race, ethnicity, and maternal education—tend to have a higher risk of poor health outcomes than the general population when exposed to the same environmental exposures. This study aimed to interpret the differences in outcomes between different population types, particularly focusing on vulnerable sub-populations, by analyzing differences arising from hypothetical small effects on these groups.

 

What were the study results?

The researchers used statistical models to examine how different levels of exposures would affect different sub-populations within the nationwide ECHO Cohort. Specifically, the study team considered a hypothetical environmental exposure that could affect a child’s birthweight. They considered four scenarios in which the hypothetical exposure could affect average birthweights in a population: a very small effect reducing average birthweight by 50g, a small effect reducing it by 125g, a medium effect reducing it by 167g, and a large effect reducing it by 250g.

The study found that the percentage of children with low birthweight (LBW) (birthweight<2500g) varied by socioeconomic categories with the greatest percentage LBW seen in the most vulnerable socioeconomic groups. After analyzing the four scenarios, a clear trend was seen such that the greatest impact of an exposure was seen in the most vulnerable sub-populations. This trend was observed for all scenarios including the impact of a small environmental exposure.

 

What was this study's impact?

This study showed how vulnerable groups, who already face higher risks of poor health, may be more affected by small environmental exposures than the general population. This demonstrates why small effects, which may be overlooked, are actually important when considering vulnerable populations. These results can be used in planning future studies and for designing preventive programs. The findings also help explain how exposures impact vulnerable groups and highlight the need to stratify by socioeconomic variables when assessing health outcomes.

 

Who was involved?

This simulation study modeled data from more than 28,000 mother-child pairs from the ECHO Cohort.

 

What happened during the study?

The research team conducted a simulation using data from ECHO Cohort participants to explore how hypothetical exposures could affect babies’ average birthweight and LBW in vulnerable subgroups. The study calculated average birthweight in groups by sociodemographic categories, and then compared the differences in average birthweight and the percentage of LBW.

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?

These findings are relevant for studies where researchers aim to identify the adverse effects of environmental exposures. Future research that uses more social factors and/or outcomes is needed to understand the impact of small environmental exposures on the general population and vulnerable sub-populations, and how these effects contribute to health disparities.

 

Where can I learn more?

Access the full journal article, titled “Do Small Effects Matter More in Vulnerable Populations? An Investigation Using Environmental influences on Child Health Outcomes (ECHO) Cohorts,” in BMC Public Health.

 

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

 

Published September 28, 2024

 

Read the associated research alert.

Download this summary

Vulnerable Populations More Likely to be Impacted by Small Environmental Effects, ECHO Study Finds

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