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Published on: December 17, 2017
Socioeconomic determinants of asthma health
Tregony Simoneau1, Jonathan M Gaffin
1Division of Pulmonary Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Insights
Socioeconomic factors significantly impact pediatric asthma. Addressing social determinants like housing and environmental exposures is crucial for improving child asthma outcomes and reducing health disparities.
Area of Science:
- Pediatric pulmonology
- Environmental health
- Health equity
Background:
- Socioeconomic factors are increasingly recognized as critical drivers of pediatric asthma incidence and morbidity.
- Social determinants of health, including housing, environmental exposures, healthcare access, and systemic racism, significantly influence asthma outcomes in children.
Purpose of the Study:
- To review and assess recent pediatric literature on socioeconomic drivers of asthma.
- To examine the impact of social determinants of health on pediatric asthma incidence and morbidity.
- To highlight the role of housing, environmental exposures, healthcare access, and systemic racism in pediatric asthma.
Main Methods:
- Systematic review of recent pediatric literature.
- Analysis of studies focusing on socioeconomic factors and asthma.
- Synthesis of evidence on social determinants of health and their impact on pediatric asthma outcomes.
Main Results:
- Children in low-income urban areas face higher exposure to indoor and outdoor asthma triggers (molds, pests, smoke, pollutants).
- Community-based asthma education (telehealth, school-based centers, peer mentors) improves medication adherence and outcomes.
- Historical racist housing policies (redlining) created persistent segregated neighborhoods with poor conditions, exacerbating asthma disparities.
Conclusions:
- Routine screening for social determinants of health is essential in clinical settings to identify at-risk pediatric asthma patients.
- Interventions targeting social risk factors show promise for improving pediatric asthma outcomes.
- Further research is needed to develop and evaluate targeted social risk interventions for pediatric asthma.
Purpose Of Review:
The current review provides an assessment of the recent pediatric literature evaluating socioeconomic drivers of asthma incidence and morbidity. The review addresses the specific social determinants of health related to housing, indoor and outdoor environmental exposures, healthcare access and quality, and the impact of systematic racism.
Recent Findings:
Many social risk factors are associated with adverse asthma outcomes. Children living in low-income, urban neighborhoods have greater exposure to both indoor and outdoor hazards, including molds, mice, second-hand smoke, chemicals, and air pollutants, all of which are associated with adverse asthma outcomes. Providing asthma education in the community - via telehealth, school-based health centers, or peer mentors - are all effective methods for improving medication adherence and asthma outcomes. The racially segregated neighborhoods created by the racist 'redlining' policies implemented decades ago, persist today as hotspots of poverty, poor housing conditions, and adverse asthma outcomes.
Summary:
Routine screening for social determinants of health in clinical settings is important to identify the social risk factors of pediatric patients with asthma. Interventions targeting social risk factors can improve pediatric asthma outcomes, but more studies are needed related to social risk interventions.
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