The goal of this study was to assess the relationship between type and quality of housing and childhood asthma in an urban community with a wide gradient of racial/ethnic, socioeconomic, and housing characteristics. A parent-report questionnaire was distributed in 26 randomly selected New York City public elementary schools. Type of housing was categorized using the participants' addresses and the Building Information System, a publicly-accessible database from the New York City Department of Buildings. Type of housing was associated with childhood asthma with the highest prevalence of asthma found in public housing (21.8%). Residents of all types of private housing had lower odds of asthma than children living in public housing. After adjusting for individual-and community-level demographic and economic factors, the relationship between housing type and childhood asthma persisted, with residents of private family homes having the lowest odds of current asthma when compared to residents of public housing (odds ratio: 0.51; 95% confidence interval, 0.22, 1.21). Factors associated with housing quality explain some of the clustering of asthma in public housing. For example, the majority (68.7%) of public housing residents reported the presence of cockroaches, compared to 21% of residents of private houses. Reported cockroaches, rats, and water leaks were also independently associated with current asthma. These findings suggest differential exposure and asthma risk by urban housing type. Interventions aimed at reducing these disparities should consider multiple aspects of the home environment, especially those that are not directly controlled by residents.
Introduction
Although it is federally-mandated that racial/ethnic minorities be included in research studies, recruiting diverse populations remains a challenge. This is particularly difficult when research involves children. The purpose of this study was to assess attitudes and beliefs toward medical research among a racially and socioeconomically diverse population of parents of school children.
Methods
A cross-sectional parent-report survey was conducted in New York City public elementary schools using stratified random selection to obtain a diverse population. Fear of medical research and likelihood to participate in medical research were assessed using a validated questionnaire. Differences in fear/likelihood to participate in research across race/ethnicity and socioeconomic characteristics were evaluated.
Results
In general, parents were afraid of their child “being treated as a guinea pig”, but were willing to allow their child to participate in research if asked by their own doctor. Factors associated with a lower score on fear towards research were; primary language other than English (OR=0.59), access to an interpreter (OR=0.73) and access to medical service within a day (OR=0.51). Latinos had the highest fear score (OR=1.87) compared to Whites. Asians were the ethnic group most likely to participate in research (OR=1.71). Low education level (OR=2.18) and public health insurance (OR=1.37) were associated with a higher score for likelihood of allowing one’s child to participate in medical research.
Conclusion
Minority parents reported more fear allowing their children to participate in medical research, but were as likely to consent their children’s participation, especially if asked by their own physician.
Asthma, respiratory infections, colds, eye irritation, nasal congestion, and sore throat were associated with the classroom environment. Results indicate that the school environment could affect teachers' respiratory health. Further assessments are necessary to establish causation.
The comorbidity of overweight and asthma has a large impact on urban populations, causing greater disease burden than asthma alone. Overweight asthmatics show more uncontrolled asthma, evidenced by emergency department visits, quick-relief medication use, and days with asthma symptoms. The relationship between socioeconomic factors and the asthma-obesity comorbidity may vary by gender and requires further study to identify successful interventions to reduce disease in children.
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