Study debunks inner-city asthma link

For more than 50 years, the conventional wisdom about asthma has been that it thrives in poor, densely populated urban areas. Researchers have even gone so far as to declare an “inner-city asthma epidemic.” But they’ve never actually checked whether asthma is more common in city centers than in suburbs or rural areas.

Until now.

A study published this week in the Journal of Allergy and Clinical Immunology compared asthma rates among children in census tracts across the country and found that kids in inner-city neighborhoods were no more likely to have asthma than kids who live elsewhere.

Asthma is a lung disease that affects more than 25 million Americans, including about 7 million children, according to the National Heart, Lung and Blood Institute. These people have inflamed airways that are prone to swelling, which makes it very difficult to breathe. In extreme cases, an asthma attack can be fatal.

People living in poor urban areas may be particularly susceptible to asthma for a variety of environmental and cultural reasons. Indoor allergens from rodents and cockroaches can trigger an attack, as can pollutants like cigarette smoke and particles from diesel exhaust. Being poor also is associated with worse diets, more stress and less breast-feeding – all risk factors for asthma.

Researchers from Johns Hopkins University used data from the National Health Interview Survey to gauge the prevalence of asthma in city centers and compare the results to that of suburban and rural areas. The NHIS is conducted by the Centers for Disease Control and Prevention and includes questions about whether subjects have ever been diagnosed with asthma, whether they’ve had an asthma attack in the past year, and whether any recent attacks have been bad enough to send them to a hospital emergency room. The researchers focused on data from 23,065 children between ages 6 and 17 who were interviewed between 2009 and 2011.

Their first pass at the data revealed that 12.9 percent of children who lived in inner-city neighborhoods had asthma, compared with 10.9 percent of children who lived in all other kinds of neighborhoods. But when the researchers factored in things like the children’s race and ethnicity, gender, age and the region of the country where they lived, the gap between inner-city and non-inner-city asthma rates became too small to be statistically significant, according to the study.

“There were no differences in asthma prevalence in suburban, small-town, and rural neighborhoods compared with urban neighborhoods,” the researchers wrote, debunking widely held beliefs to the contrary.

Asthma prevalence within city centers varied widely in different parts of the country. In the West, for instance, only 7.9 percent of inner-city children had asthma, while in the Northeast that figure was 17.3 percent.

In fact, the researchers found that medium-sized cities in the Northeast and Midwest along with suburban neighborhoods in the Northeast had higher asthma prevalence than inner-city neighborhoods in any part of the country. A child’s neighborhood type didn’t matter as much as his or her racial, ethnic and socioeconomic factors.

Puerto Rican children had the highest prevalence of asthma (19.8 percent) among all the racial and ethnic groups in the study, followed by African-American children (17.1 percent). The lowest prevalence was seen among Asian-American children (8.1 percent), non-Puerto Rican Latino children (8.8 percent) and white children (9.6 percent).

Only three factors were linked with a higher risk of a recent asthma attack and a recent ER visit: African-American or Puerto Rican ancestry and a low household income. But children with these backgrounds live all over the country – not just in inner cities, the researchers wrote.

“In recent years, the fastest growth in high-poverty areas has occurred in suburban and smaller metropolitan areas,” they wrote. “The suburbanization of poverty means that despite continued high rates of concentrated poverty in cities, there are now more poor people living in suburban than urban communities.”

Talk to us

> Give us your news tips.

> Send us a letter to the editor.

> More Herald contact information.

More in Local News

Trader Joe’s customers walk in and out of the store on Monday, Nov. 20, 2023 in Everett, Washington. (Olivia Vanni / The Herald)
New Trader Joe’s opens this week at Everett Mall

It’s a short move from a longtime location, essentially across the street, where parking was often an adventure.

Ian Bramel-Allen enters a guilty plea to second-degree murder during a plea and sentencing hearing on Wednesday, March 6, 2024, at Snohomish County Superior Court in Everett, Washington. (Ryan Berry / The Herald)
‘Deep remorse’: Man gets 17 years for friend’s fatal stabbing in Edmonds

Ian Bramel-Allen, 44, pleaded guilty Wednesday to second-degree murder for killing Bret Northcutt last year at a WinCo.

Firefighters respond to a small RV and a motorhome fire on Tuesday afternoon in Marysville. (Provided by Snohomish County Fire Distrct 22)
1 injured after RV fire, explosion near Marysville

The cause of the fire in the 11600 block of 81st Avenue NE had not been determined, fire officials said.

Ashton Dedmon appears in court during his sentencing hearing on Tuesday, March 5, 2024, at Snohomish County Superior Court in Everett, Washington. (Ryan Berry / The Herald)
Everett Navy sailor sentenced to 90 days for fatal hit and run

Ashton Dedmon crashed into Joshua Kollman and drove away. Dedmon, a petty officer on the USS Kidd, reported he had a panic attack.

A kindergarten student works on a computer at Emerson Elementary School on Wednesday, Feb. 28, 2024, in Everett, Washington. (Ryan Berry / The Herald)
‘¡Una erupción!’: Dual language programs expanding to 10 local schools

A new bill aims to support 10 new programs each year statewide. In Snohomish County, most follow a 90-10 model of Spanish and English.

Logo for news use featuring the Tulalip Indian Reservation in Snohomish County, Washington. 220118
Woman drives off cliff, dies on Tulalip Reservation

The woman fell 70 to 80 feet after driving off Priest Point Drive NW on Sunday afternoon.

Everett
Boy, 4, survives fall from Everett fourth-story apartment window

The child was being treated at Seattle Children’s. The city has a limited supply of window stops for low-income residents.

People head out to the water at low tide during an unseasonably warm day on Saturday, March 16, 2024, at Lighthouse Park in Mukilteo, Washington. (Ryan Berry / The Herald)
Everett shatters record high temperature by 11 degrees

On Saturday, it hit 73 degrees, breaking the previous record of 62 set in 2007.

Snohomish County Fire District #4 and Snohomish Regional Fire & Rescue respond to a motor vehicle collision for a car and pole. The driver was pronounced dead at the scene, near Triangle Bait & Tackle in Snohomish. (Snohomish County Sheriff’s Office)
Police: Troopers tried to stop driver before deadly crash in Snohomish

The man, 31, was driving at “a high rate of speed” when he crashed into a traffic light pole and died, investigators said.

Alan Dean, who is accused of the 1993 strangulation murder of 15-year-old Bothell girl Melissa Lee, appears in court during opening statements of his trial on Monday, March 18, 2024, at Snohomish County Superior Court in Everett, Washington. (Ryan Berry / The Herald)
31 years later, trial opens in Bothell teen’s brutal killing

In April 1993, Melissa Lee’s body was found below Edgewater Creek Bridge. It would take 27 years to arrest Alan Dean in her death.

Logo for news use featuring the municipality of Snohomish in Snohomish County, Washington. 220118
Man dies after crashing into pole in Snohomish

Just before 1 a.m., the driver crashed into a traffic light pole at the intersection of 2nd Street and Maple Avenue.

Bodies of two men recovered after falling into Eagle Falls near Index

Two men fell into the falls and did not resurface Saturday, authorities said. After a recovery effort, two bodies were found.

Support local journalism

If you value local news, make a gift now to support the trusted journalism you get in The Daily Herald. Donations processed in this system are not tax deductible.