A child’s address is likely a significant predictor of exacerbated asthma

Getty Images 1333649400

Location, location, location. A family’s neighborhood may be a more accurate predictor of exacerbated symptoms in children who have asthma. In a new study released during the American Thoracic Society’s (ATS) 2023 annual meeting in Washington, DC, new research shows that location is more compelling than the family’s income or a parent’s level of education.

According to the study’s author, Emily Skeen, MD, a pediatric pulmonary fellow at the University of Colorado Children’s Hospital in Aurora, “social determinants of health underlie significant health disparities among children with asthma.”

“We know that these factors do not act isolation, so we used a composite score of neighborhood-level child opportunity to determine whether it would predict exacerbation-prone asthma better than individual socioeconomic indicators,” Dr. Skeen said. “We hypothesized that having fewer opportunities would be associated with being prone to asthma exacerbations.”

Researchers used the Childhood Opportunity Index (COI) 2.0 to assess the data. This method evaluates 29 measures relevant to child development across education, health/environment and social/economic areas. It’s the only composite measure of neighborhood conditions specific to children, Dr. Skeen said.

The study looked at 193 Denver-area children, ages 8-17, who had asthma and were participating in an observational study at a tertiary care hospital. Specifically, researchers considered the child’s risk factor, diagnostic test, treatment or other intervention without trying to modify it. They computed the COI from the child’s home address while gathering household income and parental educational attainment. Asthma status was classified as asthma-null (no exacerbations in the previous five years) or exacerbation-prone (one or more exacerbation within the previous year).

The exacerbation-prone group of children represented a median age of 11.8, which was younger than the “not exacerbation-prone” group. Of the total number of participants, 142 of the children were considered exacerbation prone. The biggest ethnic group represented in the study—65%—identified as Hispanic.

According to the study results, those children classified as exacerbation prone increased by 40% with a 20-point decrease in overall neighborhood-level COI. The study yielded similar results for the education and social/economic areas, however, not for health/environment. Odds of being exacerbation-prone increased 10% with a $5,000 decrease in household income, while parental education was not significantly associated with the outcome.

“Our finding that lower neighborhood-level opportunity is associated with increased risk of exacerbation-prone asthma suggests that the significant burden caused by frequent asthma exacerbations could be mediated with targeted community interventions rather than focusing on individual-level interventions alone,” said Dr. Skeen. “Our work is in line with prior studies that lower COI scores are associated with increased asthma-related emergency visits and ICU admissions, but ours is the first data published looking at how the COI predicts exacerbation prone status and how that compares to individual-level predictors.”

More in Asthma
Page 1 of 15
Next Page