Environmental Injustice Is Associated With Poorer Asthma Outcomes in School-Age Children With Asthma in Metropolitan Atlanta, Georgia

Copyright © 2024 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved..

BACKGROUND: Environmental justice mandates that no person suffers disproportionately from environmental exposures. The Environmental Justice Index (EJI) provides an estimate of the environmental burden for each census tract but has not yet been used in asthma populations.

OBJECTIVE: We hypothesized that children from census tracts with high environmental injustice determined by the EJI would have a greater burden of asthma exacerbations, poorer asthma control, and poorer lung function over 12 months.

METHODS: Children aged 6 to 18 years with asthma (N = 575) from metropolitan Atlanta, Georgia, completed a baseline research visit. Participant addresses were geocoded to obtain the EJI Social-Environmental Ranking for each participant's census tract, which was divided into tertiles. Medical records were reviewed for 12 months for asthma exacerbations. A subset of participants completed a second research visit involving spirometry and questionnaires.

RESULTS: Census tracts with the greatest environmental injustice had more racial and ethnic minorities, lower socioeconomic status, more hazardous exposures (particularly to airborne pollutants), and greater proximity to railroads and heavily trafficked roadways. Children with asthma residing in high injustice census tracts had a longer duration of asthma, greater historical asthma-related health care utilization, poorer asthma symptom control and quality of life, and more impaired lung function. By 12 months, children from high injustice census tracts also had more asthma exacerbations with a shorter time to exacerbation and persistently more symptoms, poorer asthma control, and reduced lung function.

CONCLUSIONS: Disparities in environmental justice are present in metropolitan Atlanta that may contribute to asthma outcomes in children. These findings require an additional study and action to improve health equity.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - year:2024

Enthalten in:

The journal of allergy and clinical immunology. In practice - (2024) vom: 18. Feb.

Sprache:

Englisch

Beteiligte Personen:

Grunwell, Jocelyn R [VerfasserIn]
Mutic, Abby D [VerfasserIn]
Ezhuthachan, Idil D [VerfasserIn]
Mason, Carrie [VerfasserIn]
Tidwell, Mallory [VerfasserIn]
Caldwell, Cherish [VerfasserIn]
Norwood, Jalicae [VerfasserIn]
Zack, Sydney [VerfasserIn]
Jordan, Natalie [VerfasserIn]
Fitzpatrick, Anne M [VerfasserIn]

Links:

Volltext

Themen:

Air pollution
Asthma control
Asthma exacerbation
Asthma in children
Disparity
Environment
Environmental Justice Index
Health equity
Journal Article
Social determinants of health

Anmerkungen:

Date Revised 29.03.2024

published: Print-Electronic

Citation Status Publisher

doi:

10.1016/j.jaip.2024.02.015

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM368681211