Poor housing is associated with asthma morbidity

A new study found that the well-documented racial/ethnic disparities in asthma diagnosis and morbidity are diminished after accounting for material hardship. Compared with their peers, children who experience such hardship-especially by living in a poorly maintained home-are more likely to have an asthma diagnosis and its associated complications, according to data from the 2011 American Housing Survey (AHS) and follow-up surveys.

The 33,201 households from the AHS that investigators surveyed included children aged from 6 to 17 years. The study sample was primarily non-Hispanic white and also included non-Hispanic blacks and Hispanics. Investigators inquired about childhood asthma diagnoses and emergency department (ED) visits for asthma and evaluated material-hardship variables such as poor housing quality, house crowding, lack of household amenities, home ownership, and availability of a vehicle.

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Non-Hispanic black heads of household were more likely to have a child with an asthma diagnosis than non-Hispanic white heads of household and to be more likely to visit the ED. However, after adjusting for material hardship and home ownership, the race-asthma association was decreased, but not eliminated. In addition, poor housing quality was independently associated with asthma diagnosis (Hughes HK, et al. Acad Pediatr. 2017;17[2]:127-134).

Thoughts for Dr Burke

So, in the racial/ethnic disparities in asthma, quality of housing matters. Beyond that, home ownership, perhaps as a measure of wealth versus income, also matters. It is worth investigating resources in your community for asthma home visits targeting elimination of triggers and improvement in the overall housing quality.