Home asthma triggers: barriers to asthma control in Chicago Puerto Rican children

Area of Science:

• Environmental Health
• Pediatric Asthma
• Urban Health Disparities

Background:

• High-risk urban children, particularly Puerto Rican youth in Chicago, face significant asthma burdens.
• Understanding home asthma triggers is crucial for developing targeted interventions.
• Project CURA investigated environmental factors contributing to asthma morbidity in this vulnerable population.

Purpose of the Study:

• To objectively measure and contextualize asthma triggers in the homes of urban high-risk Puerto Rican children and adolescents with asthma.
• To identify factors associated with asthma trigger exposure.
• To inform environmental interventions aimed at reducing asthma-related morbidity.

Main Methods:

• Baseline home assessments were conducted, including caregiver interviews, visual home inspections, and saliva cotinine analysis.
• A trigger behavior summary score was developed to quantify exposure.
• Statistical models were used to identify associations between demographic, clinical, and psychosocial factors and trigger scores.

Main Results:

• Inspected housing was often old, multi-unit, and structurally deficient, containing numerous allergic and irritant triggers.
• Controller medication use and private insurance were linked to lower trigger behavior scores.
• Caregiver depression, perceived stress, and child negative life events correlated with higher trigger scores.

Conclusions:

• Home environments of high-risk urban Puerto Rican children contain numerous asthma triggers.
• Modifiable factors like controller medication, insurance status, and caregiver stress are associated with trigger exposure.
• Environmental interventions targeting these factors hold potential for reducing asthma morbidity in this population.