Housing mobility program effects on ambient fine particulate matter exposure and childhood asthma morbidity

Air pollution in high-poverty neighborhoods contributes to disparities in asthma morbidity. Housing mobility programs help families move to better-resourced neighborhoods and improve asthma outcomes. Whether housing mobility-related improvements in asthma morbidity are explained by reductions in air pollution is unknown.

Evaluate change in concentrations of fine particulate matter and its components and associated changes in asthma morbidity among a cohort of children with asthma who moved out of high-poverty neighborhoods.

Caregiver-reported asthma exacerbations, symptoms, and asthma control test scores were examined among 123 children (age 5-17) with persistent asthma participating in the Baltimore Regional Housing Partnership housing mobility program. Exposures considered are annual average concentrations of PM2.5 and major PM2.5 components (black carbon, organic carbon, ammonium, nitrate, and sulfate). Children moved to neighborhoods with 0.64 μg/m3 [95% CI: 0.50-0.82] lower PM2.5 concentrations, with greatest reductions in black carbon and organic carbon. One standard deviation higher exposure to PM2.5 was associated with a 60% [95% CI: 21%-112%] higher odds of exacerbations and 20% [14%-27%] higher odds of symptom days/2 weeks. Reductions in PM2.5 exposure explained 77% [39% - 100%] and 22% [16%-36%] of moving-related reductions in exacerbations and symptom days, respectively. Some PM components were also associated with asthma exacerbations and symptoms and showed mediating effects.

Moving from high-poverty neighborhoods to better-resourced neighborhoods through a housing mobility program is associated with lower air pollution exposure, contributing to moving-related asthma improvements. Housing mobility may be a useful complement to pollution-focused environmental justice interventions.