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Unsafe neighborhoods linked to children’s asthma through caregiver stress

Published: October 06, 2021

Children living in low-income urban environments experience a higher risk of uncontrolled asthma. A body of research has linked neighborhood characteristics (for example, exposure to violence and crime in the neighborhood) to children’s asthma outcomes. Another area of research has found associations between family-level factors, such as caregiver depression, and children’s asthma morbidity. However, limited research has examined the connection between neighborhood-level and family-level factors in children’s asthma outcomes.

In an article recently published in The Journal of Allergy and Clinical Immunology: In Practice, Rodríguez et al. analyzed baseline data from 140 families who participated in the Baltimore Regional Housing Partnership, an urban housing mobility program that supports families living in high-poverty neighborhoods with moving to low-poverty neighborhoods. The researchers examined the associations of caregiver-reported neighborhood safety, stress and depressive symptoms, and children’s asthma morbidity in children between the ages of 5 and 17 with persistent asthma or a recent exacerbation. The analyses aimed to determine whether the association between neighborhood safety and children’s asthma outcomes was mediated through caregiver stress and depressive symptoms.

Children in the study experienced one of three common asthma symptoms (coughing, wheezing, or chest tightness, nocturnal awakening, or slowed activity) for an average of 7.1 days within a two-week period. Most caregivers rated their neighborhoods as safe or very safe, although about a third rated them as unsafe or very unsafe. Lower neighborhood safety, and higher caregiver stress and depressive symptoms, were each associated with higher asthma symptoms, but not exacerbations, after accounting for children’s age and sex. For children living in unsafe or very unsafe neighborhoods (but not safe or very safe neighborhoods), caregiver stress partially accounted for the association between neighborhood safety and children’s asthma symptoms. The results suggest that children with asthma may benefit most from interventions at multiple levels, including both the family and neighborhood systems.  

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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