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Neighborhood poverty, urban residence, race/ethnicity, and asthma: Rethinking the inner-city asthma epidemic.
J Allergy Clin Immunol 2015; 135(3):655-62JA

Abstract

BACKGROUND

Although it is thought that inner-city areas have a high burden of asthma, the prevalence of asthma in inner cities across the United States is not known.

OBJECTIVE

We sought to estimate the prevalence of current asthma in US children living in inner-city and non-inner-city areas and to examine whether urban residence, poverty, or race/ethnicity are the main drivers of asthma disparities.

METHODS

The National Health Interview Survey 2009-2011 was linked by census tract to data from the US Census and the National Center for Health Statistics. Multivariate logistic regression models adjusted for sex; age; race/ethnicity; residence in an urban, suburban, medium metro, or small metro/rural area; poverty; and birth outside the United States, with current asthma and asthma morbidity as outcome variables. Inner-city areas were defined as urban areas with 20% or more of households at below the poverty line.

RESULTS

We included 23,065 children living in 5,853 census tracts. The prevalence of current asthma was 12.9% in inner-city and 10.6% in non-inner-city areas, but this difference was not significant after adjusting for race/ethnicity, region, age, and sex. In fully adjusted models black race, Puerto Rican ethnicity, and lower household income but not residence in poor or urban areas were independent risk factors for current asthma. Household poverty increased the risk of asthma among non-Hispanics and Puerto Ricans but not among other Hispanics. Associations with asthma morbidity were very similar to those with prevalent asthma.

CONCLUSIONS

Although the prevalence of asthma is high in some inner-city areas, this is largely explained by demographic factors and not by living in an urban neighborhood.

Authors+Show Affiliations

Division of Pediatric Allergy and Immunology, Johns Hopkins University School of Medicine, Baltimore, Md. Electronic address: ckeet1@jhmi.edu.Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Md.Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Md.Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, Md; Graduate Program in Clinical Investigation, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.Division of Pediatric Allergy and Immunology, Johns Hopkins University School of Medicine, Baltimore, Md.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

25617226

Citation

Keet, Corinne A., et al. "Neighborhood Poverty, Urban Residence, Race/ethnicity, and Asthma: Rethinking the Inner-city Asthma Epidemic." The Journal of Allergy and Clinical Immunology, vol. 135, no. 3, 2015, pp. 655-62.
Keet CA, McCormack MC, Pollack CE, et al. Neighborhood poverty, urban residence, race/ethnicity, and asthma: Rethinking the inner-city asthma epidemic. J Allergy Clin Immunol. 2015;135(3):655-62.
Keet, C. A., McCormack, M. C., Pollack, C. E., Peng, R. D., McGowan, E., & Matsui, E. C. (2015). Neighborhood poverty, urban residence, race/ethnicity, and asthma: Rethinking the inner-city asthma epidemic. The Journal of Allergy and Clinical Immunology, 135(3), pp. 655-62. doi:10.1016/j.jaci.2014.11.022.
Keet CA, et al. Neighborhood Poverty, Urban Residence, Race/ethnicity, and Asthma: Rethinking the Inner-city Asthma Epidemic. J Allergy Clin Immunol. 2015;135(3):655-62. PubMed PMID: 25617226.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neighborhood poverty, urban residence, race/ethnicity, and asthma: Rethinking the inner-city asthma epidemic. AU - Keet,Corinne A, AU - McCormack,Meredith C, AU - Pollack,Craig E, AU - Peng,Roger D, AU - McGowan,Emily, AU - Matsui,Elizabeth C, Y1 - 2015/01/20/ PY - 2014/08/02/received PY - 2014/10/09/revised PY - 2014/11/13/accepted PY - 2015/1/25/entrez PY - 2015/1/27/pubmed PY - 2015/5/1/medline KW - Inner-city asthma KW - childhood asthma KW - neighborhood KW - race/ethnicity KW - urban/rural SP - 655 EP - 62 JF - The Journal of allergy and clinical immunology JO - J. Allergy Clin. Immunol. VL - 135 IS - 3 N2 - BACKGROUND: Although it is thought that inner-city areas have a high burden of asthma, the prevalence of asthma in inner cities across the United States is not known. OBJECTIVE: We sought to estimate the prevalence of current asthma in US children living in inner-city and non-inner-city areas and to examine whether urban residence, poverty, or race/ethnicity are the main drivers of asthma disparities. METHODS: The National Health Interview Survey 2009-2011 was linked by census tract to data from the US Census and the National Center for Health Statistics. Multivariate logistic regression models adjusted for sex; age; race/ethnicity; residence in an urban, suburban, medium metro, or small metro/rural area; poverty; and birth outside the United States, with current asthma and asthma morbidity as outcome variables. Inner-city areas were defined as urban areas with 20% or more of households at below the poverty line. RESULTS: We included 23,065 children living in 5,853 census tracts. The prevalence of current asthma was 12.9% in inner-city and 10.6% in non-inner-city areas, but this difference was not significant after adjusting for race/ethnicity, region, age, and sex. In fully adjusted models black race, Puerto Rican ethnicity, and lower household income but not residence in poor or urban areas were independent risk factors for current asthma. Household poverty increased the risk of asthma among non-Hispanics and Puerto Ricans but not among other Hispanics. Associations with asthma morbidity were very similar to those with prevalent asthma. CONCLUSIONS: Although the prevalence of asthma is high in some inner-city areas, this is largely explained by demographic factors and not by living in an urban neighborhood. SN - 1097-6825 UR - https://www.unboundmedicine.com/medline/citation/25617226/Neighborhood_poverty_urban_residence_race/ethnicity_and_asthma:_Rethinking_the_inner_city_asthma_epidemic_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-6749(14)01676-5 DB - PRIME DP - Unbound Medicine ER -