Neighborhood factors could increase your child’s risk of asthma

By By Denise Mann Health Day Reporter, health day reporter

(Health Day)

MONDAY, July 25, 2022 (HealthDay News) — Children in inner-city neighborhoods are known to be at higher risk for uncontrolled asthma. Now, new research suggests that violent crime and poor academic performance could be two reasons.

“Being a victim of violent crime can lead to toxic stress, and lower educational attainment is associated with poor health literacy,” said study author Dr. Jordan Tyris, a hospitalist at Children’s National Hospital in Washington, DC. “Toxic stress and low health literacy are associated with worsening asthmatic health in children, so it is possible that this could explain our findings.

Health literacy refers to how well a person understands and processes the information needed to make appropriate healthcare choices.

Yet other factors not addressed in the new study could also be at play, including structural racism and access to health care, Tyris said.

For the study, his team analyzed data from nearly 15,500 children with asthma (ages 2 to 17) in Washington, DC. emergency department for asthma attacks, the study showed.

Turning this around will take a village, Tyris said.

Expanding community college options for adults and providing better early childhood education programs in these neighborhoods can make a significant difference in academic achievement and health literacy.

“We recommend that community interventions focus on the population in neighborhoods where rates of emergencies and hospitalizations are increasing,” Tyris said. “Engaging community members and other stakeholders to create these interventions and address these important social factors could lead to lower asthma [rates] among children living in these areas.

The study was published online July 25 in the journal Pediatrics.

The results mirror what Dr. Kevin Fiori sees in his Bronx, New York-based practice. He is Director of Social Determinants of Health and Community and Population Health at Montefiore Medical Center and Assistant Professor of Pediatrics at Albert Einstein College of Medicine.

“Adverse social determinants of health, which include unstable housing or poor housing conditions as well as other environmental factors, can negatively impact a person’s health in significant ways,” said Fiori, who reviewed the results.

It’s time to think outside the box, he said.

“This new study…demonstrates why it is important to partner with families who may already be performing all of the medical interventions we recommend, but who are struggling with the underlying factors of asthma exacerbations, which could be molds or pests present in a family’s household,” Fiori says.

He said parents of children with asthma should tell their pediatrician what is going on at home as it may affect their child’s health, and help is available.

“Primary care providers and pediatricians can partner with our patients in meaningful ways, such as directing them to dietary resources, writing letters to landlords explaining how living conditions worsen a patient’s asthma and advocating with representatives about the importance of safe neighbors to family health,” Fiori said.

For example, the New York City Health Department’s Healthy Homes program does free home assessments and will work with homeowners to resolve any issues, Fiori said.

“Years ago, we found that interventions such as bringing an exterminator to the homes of nearly 400 pediatric patients with persistent asthma could reduce allergy symptoms,” he recalls.

Greater collaboration with community health workers can also make a difference in the health and well-being of these children, Fiori added.

“By integrating community health workers and other partners into our team with the common goal of addressing a person’s ‘whole health’, we can begin to more effectively provide patients with expertise and resources as well as ‘to help families navigate available social services,’ Fiori said.

SOURCES: Jordan Tyris, MD, hospitalist, Children’s National Hospital, Washington DC; Kevin Fiori, MD, MPH, MSc, director, social determinants of health and community and population health, Montefiore Medical Center, and assistant professor, pediatrics, Albert Einstein College of Medicine, Bronx, NY; PediatricsAugust 2022

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