Neighborhood-Level Factors Related to Asthma in Children Living in Urban Areas.
Kelli DePriest, Arlene Butz
PMID 27756873WHAT IT FOUND
Asthma in urban children was associated with neighborhood air pollution, housing triggers, crime, and family stress.
These are associations, not evidence that reducing them improves asthma.
Key findings
01Asthma rates were significantly higher for African American or Puerto Rican children in two large national studies, and a one-unit decrease in household income to poverty ratio was associated with a 7% increase in the odds of prevalent asthma.
02The review reported strong evidence supporting an association between nitrogen dioxide and asthma. A 5 ppb increase in average nitrogen dioxide during the first year of life was associated with higher odds of asthma (odds ratio 1.17).
03In New York City public housing, asthma prevalence was 21.8%, and residents were more likely to report cockroaches (68.7% vs. 21%) than residents of other housing types.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included only nonexperimental studies, so it cannot show that changing air pollution, housing, safety, or stress causes asthma to improve. Most studies were cross-sectional or used secondary data, so cause and effect cannot be inferred. Many air-quality studies used area-level pollution data rather than each child's actual exposure. Asthma was measured in different ways, including parent report, medical records, and emergency department visits, which makes studies hard to compare. Some studies did not account for socioeconomic status, sex, or ethnicity, and samples varied by location, age, and data source. The review was limited to English peer-reviewed studies from 2010 to March 2016 and focused on urban children.
Declared interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
The easy way to misread this
Do not conclude that reducing air pollution, crime, or stress will improve a child's asthma. These studies were mostly cross-sectional and show associations, not effects of interventions.