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Tenant Reported Triggers Are Associated With Pediatric Asthma Emergency Department Visits

Sophia S Carryl1, Zichuan Li1, Keith Acosta2

  • 1Department of Environmental Health (SS Carryl, Z Li, G Adamkiewicz, and AL Haber), Harvard T.H. Chan School of Public Health, Boston, Mass.

Academic Pediatrics
|March 9, 2026
PubMed

Insights

Neighborhoods with more reported in-home asthma triggers have higher rates of pediatric emergency department (ED) visits for asthma. Addressing these triggers can help reduce asthma burden in children.

Area of Science:

  • Environmental Health
  • Pediatric Asthma Research
  • Public Health

Background:

  • In-home allergen exposures significantly contribute to pediatric asthma prevalence and health disparities.
  • Asthma management is challenged by environmental factors within homes.

Purpose of the Study:

  • To investigate the link between tenant-reported in-home asthma triggers and pediatric emergency department (ED) visits for asthma at a neighborhood level.
  • To understand the impact of environmental asthma triggers on healthcare utilization.

Main Methods:

  • A retrospective cohort study analyzed 3,209 patients under 26 with 5,290 asthma-related ED visits to Boston Children's Hospital (2018-2019).
  • Included 8,230 tenant reports of in-home asthma triggers filed with the City of Boston (2017-2019).
  • Electronic health records provided medication data for a subset of patients.

Main Results:

  • Higher rates of asthma trigger reports in neighborhoods correlated with significantly increased pediatric asthma ED visits.
  • This association remained significant after adjusting for neighborhood characteristics (adjusted IRR per IQR, 1.18).

Conclusions:

  • Neighborhoods with more reported in-home asthma triggers exhibit higher pediatric asthma emergency department utilization.
  • Tenant-reported environmental triggers are a key factor in pediatric asthma healthcare needs.
Abstract

Keywords:
asthmaemergency department utilizationhousingindoor allergenssocial determinants of health

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