ECHO Social and Neighborhood Research
SOCIAL AND NEIGHBORHOOD
ECHO researchers use data from more than 64,000 children and their families across the U.S. to examine associations between neighborhood and social factors and health conditions, including obesity, asthma, pre-term birth, low birthweight, and anxiety and depression.
Resources
Visit these sites to learn more about social and neighborhood factors.
World Health Organization: Social Determinants of Health
CDC: Social Determinants of Health
QUESTIONS
For information or to request an interview, contact the ECHO Program Coordinating Center echocc@dm.duke.edu.
If you are not a member of the media, but have a general inquiry, please contact NIHKidsandEnvironment@od.nih.gov.
The ECHO Program investigates social and neighborhood factors—such as access to housing, healthy food, transportation, parks, and education—that can influence child health outcomes. The neighborhoods where children grow up play an important role in their health. Because children are still developing, they may be especially sensitive to their surroundings, which can affect their health not just in childhood but throughout their lives. Tools like the Child Opportunity Index (COI) and the Social Vulnerability Index (SVI) combine dozens of these indicators into a single measure, making it easier for researchers to explore how differences in community resources can affect children’s well-being and future opportunities.
What We're Learning
Since its launch, the ECHO Program has published more than 2,200 research articles on a wide range of child health topics. Within this body of work, many studies have examined how social and neighborhood factors shape children’s health and development.
Here are some research highlights:
ECHO Study Observes Health Disparities in Air Pollution-associated Risk of Childhood Asthma
August 1, 2025
Higher exposure to air pollutants increases childhood asthma risk, particularly for children in densely populated areas or communities with a higher proportion of Black residents.
Children Living in Low-income Neighborhoods with Low Food Access at Higher Risk of Developing Asthma, ECHO Study Finds
June 2025
Higher risks of developing asthma were seen in children from birth to age 11, and the increased risk was more noticeable in girls and Hispanic children
Children Born in Lower-Opportunity Neighborhoods Had Higher Rates of Asthma with Recurrent Exacerbations
March 2025
Non-Hispanic Black children in these neighborhoods had the highest rate of this type of asthma that requires emergency care or medical treatment.
Food Insecurity in Pregnancy & Early Life May Be Linked to Higher Chance of Obesity in Children & Adolescents
September 2024
Children who faced food insecurity during early childhood—or whose mothers experienced it during pregnancy—had a higher BMI and more than 50% increased chance of developing obesity or severe obesity in childhood and adolescence.
ECHO Study Suggests Living Near Green Space Is Associated with Lower Anxiety and Depression in Preschool-Age Kids
April 2024
Higher levels of green spaces, up to three-fourths of a mile from a child’s home, were linked with lower symptoms of anxiety and depression from ages 2 to 5.
Neighborhood-Level Poverty and Food Insecurity During Pregnancy Associated With Lower Birthweight and Small for Gestational Age Infants, NIH Study Finds
March 2024
Living in neighborhoods where residents have lower incomes, limited food access, or limited vehicle access was associated with lower birthweights and an increased risk of babies born small for gestational age.