How ECHO Advances Research on Upper and Lower Airway Health

In the U.S., an estimated 5 million children have asthma. Health disparities often begin early and persist into adulthood. In the U.S., asthma affects an estimated 5 million children-with higher rates for children living in poverty (11%), boys ages 5-14 (11%), and Black children (14%). Each year, children with poorly managed asthma experience more than 10 million missed school days, 74,000 hospital stays, and 767,000 trips to the emergency room1. 

Many factors can affect a child's airway health and disease and whether a child might develop breathing problems or respiratory diseases such as asthma. Research by the NIH Environmental influences on Child Health Outcomes (ECHO) Program explores the social, physical, and behavioral factors that affect children's airway health. The focus is on understanding the early stages of airway health and disease, which may start during fetal development. It can also help to explain how a child's airway function might affect other areas of their health and well-being during childhood and adolescence. This research can help inform programs, policies, and practices that address health differences from the beginning, promoting a lifetime of good health that continues for generations. 

What We're Learning

The ECHO Program has published more than 1,500 articles about the results of its research, including many that

Here are recent examples of ECHO research:

Specific Social, Environmental Factors May Influence Incidence Rates of Childhood Asthma with Recurrent Exacerbations
March 2023
Rates of childhood asthma with frequent flare-ups were highest among children ages 2-4 years and those with a parental history of asthma.  

ECHO Study Suggests Link Between Severe Bronchiolitis During Infancy and Asthma During Childhood
December 2022
Hospitalized infants with bronchiolitis seemed more likely to develop asthma by age 12 when compared to hospitalized infants without bronchiolitis.   

ECHO Study Links Poor Neighborhood Conditions With Higher Risk of Asthma in Children
May 2022
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. 

ECHO Study Suggests Higher Risk of Obesity for Children With Asthma
September 2021
Children with asthma had a higher risk of developing obesity than children without asthma. Among children with asthma, those using asthma medication had a dramatically lower risk of obesity.  

How much vitamin D do children with asthma and increased body weight need to correct low vitamin D levels?
August 2023
An ECHO ISPCTN study found that administering a 50,000 IU vitamin D dose on the first day, followed by 8,000 IU daily for 16 weeks, effectively and safely raised vitamin D levels to recommended levels in children with asthma and increased body weight.