Asthma and the social determinants of health

Grant, Torie; Croce, Emily; Matsui, Elizabeth C.

doi:10.1016/j.anai.2021.10.002

Cited by 98 publications

(52 citation statements)

References 80 publications

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“…Social determinants of health (SDoH) are non‐medical influences that affect health outcomes 75 and include the conditions in which people are born, grow up, go to school and work, live, and age. SDoH are becoming increasingly recognized as important risk factors for pediatric urban asthma 11,76 . Here, we will discuss poverty, housing, obesity, and stress in the context of pediatric urban asthma.…”

Section: Social Determinants Of Health (Sdoh) In Urban Neighborhoodsmentioning

confidence: 99%

“…80 Poverty's effects on asthma are likely multifactorial, encompassing disparities in housing, education, employment, exposure to pests and pollution, limited health literacy, and access to health care. 11 Housing quality is an important SDoH, with racial and ethnic minority populations being more likely to reside in housing considered substandard or in poor repair, which contributes to environmental health disparities. 81 Substandard urban housing is a risk factor for mouse and cockroach exposure as poor housing conditions contribute to pest infestation, [16][17][18] which has been highlighted above as being associated with asthma risk and morbidity.…”

Section: So Cial De Terminants Of He Alth (S Doh) In Urban Nei G Hbor...mentioning

confidence: 99%

“…Low income is also associated with asthma exacerbations and asthma morbidity 80 . Poverty's effects on asthma are likely multifactorial, encompassing disparities in housing, education, employment, exposure to pests and pollution, limited health literacy, and access to health care 11 …”

Section: Social Determinants Of Health (Sdoh) In Urban Neighborhoodsmentioning

confidence: 99%

“…Children living in urban neighborhoods are at increased risk of exposures known to be associated with asthma and asthma morbidity, such as pest allergens and mold as well as indoor and outdoor pollutants 10 . Additionally, children living in urban neighborhoods experience disadvantageous social determinants of health including increased poverty, poor housing quality, increased rates of obesity, and increased stress, all of which can contribute to asthma risk and morbidity 11 1), and discuss opportunities for intervention which could help to mitigate asthma disparities among urban children with asthma (Table 1).…”

Section: Introductionmentioning

confidence: 99%

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The influence of urban exposures and residence on childhood asthma

Grant

Wood

2022

Pediatric Allergy Immunology

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Children with asthma who live in urban neighborhoods experience a disproportionately high asthma burden, with increased incident asthma and increased asthma symptoms, exacerbations, and acute visits and hospitalizations for asthma. There are multiple urban exposures that contribute to pediatric asthma morbidity, including exposure to pest allergens, mold, endotoxin, and indoor and outdoor air pollution. Children living in urban neighborhoods also experience inequities in social determinants of health, such as increased poverty, substandard housing quality, increased rates of obesity, and increased chronic stress. These disparities then in turn can increase the risk of urban exposures and compound asthma morbidity as poor housing repair is a risk factor for pest infestation and mold exposure and poverty is a risk factor for exposure to air pollution. Environmental interventions to reduce in‐home allergen concentrations have yielded inconsistent results. Population‐level interventions including smoking bans in public places and legislation to decrease traffic‐related air pollution have been successful at reducing asthma morbidity and improving lung function growth. Given the interface and synergy between urban exposures and social determinants of health, it is likely population and community‐level changes will be needed to decrease the excess asthma burden in children living in urban neighborhoods.

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Section: Social Determinants Of Health (Sdoh) In Urban Neighborhoodsmentioning

confidence: 99%

Section: So Cial De Terminants Of He Alth (S Doh) In Urban Nei G Hbor...mentioning

confidence: 99%

Section: Social Determinants Of Health (Sdoh) In Urban Neighborhoodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The influence of urban exposures and residence on childhood asthma

Grant

Wood

2022

Pediatric Allergy Immunology

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“…Access to environmental measures that may ameliorate the impact of aeroallergen exposure, such as dust mite covers, reductions in humidity, mold amelioration measures, and indoor climate control are also less accessible to those facing adverse social determinants of health. 14 , 80 …”

Section: Allergen Exposure In An Era Of Global Changementioning

confidence: 99%

Allergen Management in Children with Type 2-High Asthma

Gray-Ffrench¹,

Fernandes²,

Sinha³

et al. 2022

JAA

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Children exposed to various indoor and outdoor allergens are placed at an increased risk of developing asthma in later life, with sensitization in these individuals being a strong predictor of disease morbidity. In addition, aeroallergen exposure influences asthma outcomes through an interplay with adverse determinants of health. The goal of this review is to provide an introductory overview of factors related to aeroallergen exposure in type 2-high childhood asthma. These include the relevance of exposure in asthma exacerbations and severity, and the evidence-base for avoidance and treatment for sensitization to these allergens. This review will focus on both indoor aeroallergens (house dust mite, pet, cockroach, mold, and rodent) and outdoor aeroallergens (pollens and molds). Treatment of aeroallergen sensitization in children with asthma includes avoidance and removal measures, although there is limited evidence of clinical benefit especially with single-strategy approaches. We will also address the interplay of aeroallergens and climate change, adverse social determinants, and the current COVID-19 pandemic, when we have seen a dramatic reduction in asthma exacerbations and emergency department visits among children. While there are many factors that are hypothesized to contribute to this reduction, among them is a reduced exposure to outdoor seasonal aeroallergens.

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