Does residential ‘greenspace’ help asthma control?

A study in 150 asthmatic children (aged 9 to 17 years) found an interaction between family relationships and residential greenspace, suggesting that children with asthma benefit when they live in high greenspace areas and have positive family relationships.

Parents completed a questionnaire about parenting practices to assess how often they engaged in harsh or inconsistent parenting behaviors. Children completed a questionnaire to measure how often parents behaved hostilely; for example, by yelling, criticizing, or insulting them. Investigators also ascertained how well each child’s asthma was controlled and the limitations it imposed, as well as the degree of airway inflammation and glucocorticoid receptor expression in T-helper cells. Residential greenspace also was calculated.

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The investigation found that living in areas high in greenspace in and of itself has few main effects on asthma outcomes. Nonetheless, investigators documented interactions suggesting that as family environments become less negative, greenspace has more beneficial links to clinical outcomes such as asthma control, and to disease-relevant biologic processes such as airway inflammation. These findings could not be explained by socioeconomic, demographic, or medical variables (Chen E, et al. Pediatrics. 2017;139[4]:e20163056).

Thoughts from Dr Burke

This article shows again that children with asthma and other chronic diseases need to be considered in the context of their home, their family, and their neighborhood. The child interacts with each of these factors while the factors influence each other. Nothing is simple.