Prevalence Of Pediatric Asthma Research Articles

Environmental Exposure and Pediatric Asthma Prevalence in Saudi Arabia: A Cross-Sectional Study.

Asthma is a chronic respiratory disease characterized by recurrent episodes of wheezing and shortness of breath. Currently, there is no cure for asthma. However, through accurate diagnosis, appropriate therapy, and effective management strategies, individuals with asthma can achieve a better quality of life. This study focused on determining the prevalence and environmental risk factors of pediatric asthma among children in Saudi Arabia. This cross-sectional study was undertaken from January 2023 to August 2023, encompassing five key regions in Saudi Arabia: Central, Eastern, Northern, Southern, and Western. A structured online questionnaire was disseminated to parents/guardians of children aged 2-18 with a confirmed diagnosis of asthma. The objective was to garner insights regarding pediatric asthma prevalence and associated risk factors within these regions. The questionnaire was designed with considerations for sociodemographic factors, environmental exposures, and known asthma triggers. From the survey's distribution, a total of 1666 responses were accumulated and processed for further analysis. The survey saw the participation of 1666 respondents. The age bracket of 8-13 years had the highest representation, accounting for 52.5% of the total participants. From the total cohort, 26.9% had been diagnosed with pediatric asthma. It was also observed that 56.7% of the participants resided in areas marked by high traffic or were proximate to busy roads. Additionally, 30.7% of the respondents pinpointed specific times in the year when asthma symptoms intensified. When dissecting the data, it was discerned that there were statistically significant associations between the prevalence of pediatric asthma, gender, and the regions of Saudi Arabia with reference to air pollution exposure. Notably, gender had an odds ratio of 1.12, while the regional distribution held an odds ratio of 1. Our study vividly highlights the intricate landscape of pediatric asthma across Saudi Arabia, indicating its prevalence and drawing attention to associated risk factors. Noteworthy observations include the pronounced impact of gender and regional variances, particularly concerning air pollution exposure, on asthma incidence. The insights gleaned from this research are invaluable in steering the formulation and implementation of strategic interventions geared towards bolstering children's health and enhancing their life quality in regions bearing the brunt of pediatric asthma.

Cannabis legalization and childhood asthma in the United States: An ecologic analysis

Cannabis use is increasing among adults with children in the home particularly in states with cannabis legalization for medical (MCL) and/or recreational use (RCL), relative to states where cannabis use remains illegal at the state level. Exposure to secondhand smoke is a key risk factor for asthma among children. The objective of the current study was to investigate the relationship between MCL and RCL and the state-level prevalence of asthma among children in the United States (US). This ecological study used data from the 2011to 2019 National Survey on Children's Health, a representative sample of the population of minor children in the US. Changes in the annual prevalence of pediatric asthma by RCL/MCL over time were estimated using difference-in-difference (DID) analysis. Overall, a statistically significant decrease of 1.1% in the prevalence of pediatric asthma was observed from 2011– 2012 to 2018–2019. Adjusting for sociodemographic characteristics, overall reductions in asthma over time were generally greater in states in which cannabis use is fully illegal or with recent MCL adoption, but the rate of decline did not differ statistically by RCL/MCL status. Relative to 2011–2012 and to states where cannabis is fully illegal, the prevalence of asthma increased in states with RCL among youth 12–17 years old (2018–2019 DID = 2.56, p = .028) and among youth in some NH minoritized race/ethnicity groups (2016–2017 DID = 3.88, p = .013 and 2018–2019 DID = 4.45, p = .004). More research is needed to estimate the potential consequences of increased adult use of cannabis in the community for children's respiratory health.

30: SOCIAL VULNERABILITY INDEX AND CHILD OPPORTUNITY INDEX HIGH IN ASTHMA BUT NOT LINKED TO PICU STAY

Introduction: Racial and socioeconomic disparities in pediatric asthma prevalence, severity, and use of primary and emergency care have been well studied. However, understanding of the impact of these disparities on risk of hospitalization in the pediatric intensive care unit (PICU) is limited. We used composite measures of socioeconomic risk factors through the Centers for Disease Control and Prevention (CDC) Social Vulnerability Index (SVI), and the Child Opportunity Index (COI) 2.0 to compare patients admitted for status asthmaticus to the PICU or pediatric ward at Children’s Hospital Los Angeles (CHLA). We hypothesized patients with a high SVI and low COI are at higher risk for PICU level care. Methods: Following IRB approval, patients were identified using ICD-10 codes for asthma. The outcome of interest was need for PICU versus ward care. Patients were included as requiring PICU level of care if admitted to the PICU during their stay. Patient registered street address was geocoded and linked to US Census-American Community Survey 2019 Data (5-Year) at the census tract level. Bivariate analysis with the patient’s SVI, COI, hospital length of stay (LOS), and PICU admission were conducted. Statistical analysis used SAS, STATA, and ArcGIS Pro. Results: From [October 2015 – May 2022], there were 4,766 admissions matched to addresses from 3,617 distinct patients of which 626 (13.1%) required PICU admission. Overall median SVI for all patients was 0.86 with no difference between groups for SVI: median (1,3 IQR) PICU 0.86 (0.67, 0.93) Ward 0.86 (0.69, 0.93) p=0.56; or for COI: PICU 27 (9, 50) Ward 24 (10, 50) p=0.82. Hospital LOS was significantly longer for those requiring PICU admission: PICU 3 (3, 5) Ward 2 (2, 3) (days) p< 0.001. Conclusions: We found that children admitted to CHLA for asthma had an elevated SVI overall reflecting a patient population among the lowest socioeconomic status in the United States. The median 0.86 SVI score indicates a population that is more socially vulnerable than all but 14% of the US population. Similarly, the COI score demonstrated a population at risk. Yet, there was no difference between groups for the SVI or COI scores indicating we care for children at increased socioeconomic risk, but this did not increase PICU use for asthma admissions.

Breathing Room: Industrial Zoning and Asthma Incidence Using School District Health Records in the City of Santa Ana, California.

Background: Traffic and industrial emissions are associated with increased pediatric asthma morbidity. However, few studies have examined the influence of city industrial zoning on pediatric asthma outcomes among minoritized communities with limited access to air monitoring. Methods: In this cross-sectional analysis of 39,974 school-aged students in Santa Ana, CA, we investigated the effect of proximity to areas zoned for industrial use on pediatric asthma prevalence, physical fitness, school attendance, and standardized test scores. Results: The study population was 80.6% Hispanic, with 88.2% qualifying for free/reduced lunch. Compared to students living more than 1 km away from industrial zones, those living within 0.5 km had greater odds of having asthma (adjusted OR 1.21, 95% CI 1.09 to 1.34, p < 0.001). Among children with asthma, those living between 0.5–1.0 km had greater odds of being overweight or obese (aOR 1.47, 95% CI 1.00, 2.15, p = 0.047). Industrial zone proximity was not significantly associated with worse fitness and academic outcomes for students with asthma. Conclusion: These findings suggest that industrial zone proximity is associated with increased pediatric asthma in a predominantly Latino community in Southern California.

Evaluating the Impact of Pharmacist Counselling for Asthmatic Children at Karbala Teaching Hospital for Children: An Interventional Prospective Study (Conference Paper )#

Asthma is one of the most common chronic, non-communicable diseases affecting children worldwide. The estimated prevalence of pediatric asthma in Iraq is 15.8%. Physiologic, inflammatory and structural factors contribute to the development of asthma. Assessment and monitoring of asthma control can be done by a validated children asthma control test (CACT). Management of asthma must address three components which are an appropriate management plan, the most appropriate medication if necessary, and the use of safe and effective medication. The management plan should consider patient counseling and education about the definition of asthma, signs, and symptoms, the pathophysiology of asthma, common triggers for asthma and how can avoid them, what are the rescue medication and the controller one, proper inhaler techniques, and how to monitor asthma control. Patient education accounts for 90% of success and this can be achieved by an active collaboration among health care providers. This is a prospective interventional study that aims at evaluating pharmacist counseling for asthmatic children. The study involved 105 participants whose consent was taken and underwent a face-to-face interview about asthma counseling and inhaler technique for those who use it. Ninety-two eligible participants remained. Their CACT was recorded at the first visit and then followed up weekly for one month either by phone or physical to assess asthma control. In the fourth week, a CACT was recorded and compared to the first one before intervention. There was a significant improvement in CACT after providing the counselling and weekly follow up.

Point of Care Spirometry Assessment for Pediatric Asthma Prevalence in a Family Homeless Shelter in Omaha, Nebraska

Introduction: The few studies on pediatric asthma in US homeless shelters describe a 27.9 – 39.8% prevalence, and historically Omaha has had a high incidence of fatal pediatric asthma. Thereby, Clarkson Family Medicine (CFM) residency began a pediatric asthma outreach to a local family-homeless shelter to assess the prevalence of pediatric asthma and follow-up appointment attendance.

Changes in epidemiology and clinical practice in IgE-mediated Allergy in children

In the last decades, allergic diseases have increased exponentially and although pediatric asthma prevalence is stabilizing, it is estimated around 10% in Spain. Not the same with food allergy and anaphylaxis which are clearly increasing, becoming a significant public health problem. Taking into account epidemiological trends, the European Academy of Allergy and Clinical Immunology (EAACI) estimates that in less than 15 years more than half of the European population will suffer from some type of allergic disorder.The advances in diagnostic methods in food allergy, especially component resolved diagnosis, allow us to know the patient’s sensitization profile and explain possible cross reactivity, anticipate potential risk of food trangressions, and prescribe correct avoidance diet in each patient. Thus, the development of molecular biology and nanotechnology have led to the appearance of new technologies (microarrays) which facilitate the study, specially of the polysensitized patients, allowing allergen immunotherapy (AIT) to be more personalized. The latest advances in the use of biologics are having an impact, not only in disease evolution, but also in quality of life.

CARE: an observational study of adherence to home nebulizer therapy among children with asthma.

Background:The prevalence of pediatric asthma in China is approximately 3%, and asthma remains poorly controlled in many of these patients. This study assessed the rate of adherence to home nebulizer treatment in paediatric patients in China.Methods:The CARE study was a 12-week, multicentre, prospective, observational study across 12 tertiary hospitals in China. Patients were aged 0–14 years, clinically diagnosed with asthma and prescribed home nebulizer inhaled corticosteroid (ICS) therapy for ⩾3 months. The primary endpoint was electronically monitored treatment adherence. Patients attended onsite visits at 0, 4, 8 and 12 weeks to assess asthma control, severity and treatment adherence (recorded by electronic monitoring devices and caregivers).Results:The full analysis set included 510 patients. Median treatment adherence reported by electronic monitoring devices was 69.9%, and median caregiver-reported adherence was 77.9%. The proportion of patients with well-controlled asthma increased from 12.0% at baseline to 77.5% at visit 4. Increased time between asthma diagnosis and study enrolment was a significant predictor for better adherence [coefficient: 0.01, p = 0.0138; 95% confidence interval (CI): 0.00, 0.01] and asthma control (odds ratio = 1.001, p = 0.0498; 95% CI: 1.000, 1.002). Negative attitude to treatment by the caregiver was associated with poorer asthma control.Conclusions:Adherence to home nebulization, a widely used treatment for asthma, was high among Chinese pediatric patients. Asthma control improved with increasing treatment duration. These results suggest that home nebulization of ICS is an effective and recommendable long-term treatment for paediatric patients with asthma. Trial registration ClinicalTrials.gov identifier: NCT03156998 The reviews of this paper are available via the supplemental material section.

Evaluating the strength of evidence between long-term NO2 exposure and pediatric asthma incidence for potential inclusion into the Global Burden of Disease Study

Several epidemiological studies have highlighted a relationship between NO2 exposure and increased incidence and prevalence of pediatric asthma. Recently, the Global Burden of Disease (GBD) developed a quantitative evidence scoring approach with the intention to assess the effect and strength of the evidence for exposure-response relationships with consistency across all risk factors. We use this evidence scoring approach to generate a quantitative effect estimate for NO2 exposure and childhood asthma that can be applied for burden of disease assessments. For the purpose of this work, we systematically compiled existing studies on the relationship between NO2 and childhood asthma and extracted relative risks (RR). In addition, we extracted a set of study-specific covariates in order to explain between-study heterogeneity in risk estimates. We then applied the GBD’s newly developed meta-regression tool MR-BRT (MetaRegression - Bayesian, Regularized, Trimmed) to provide a quantitative estimate of effect and strength of evidence based upon unexplained between-study heterogeneity. Preliminary analyses including 28 sources from 11 countries identified within a systematic literature review conducted by Khreis et al. in 2017 were included in the metaregression. Overall, we estimated a RR of 1.10 (95% confidence interval [CI]=0.94-1.30) per 5 ppb increase in annual average NO2 (p-value=0.13) when not accounting for study-specific covariates. A model accounting for all significant study-level covariates (‘outcomes self-reported`, ‘confounding uncontrolled’, ‘selection bias’, and ‘subpopulation’) revealed an effect estimate of 1.28 (95%CI=1.00-1.63) per 5 ppb (p-value=0.024). Findings provide strong evidence for a relationship between NO2 exposure and pediatric asthma when adjusting for between-study heterogeneity. In future steps, we will include 27 additional studies that were published after the 2017 systematic review conducted by Khreis et al. (2017). Furthermore, we will apply an automated covariate selection process in which variables are sub-selected by running a set of log-linear models with a range of Lasso penalty parameters.

Cleaning products and asthma risk: a potentially important public health concern.

[See related article at [www.cmaj.ca/lookup/doi/10.1503/cmaj.190819][2]][2] KEY POINTS Prevalence of pediatric asthma in Canada is 13% and has increased over time.[1][2] Asthma often begins early in childhood, and lifelong complications, including airway remodelling, can begin as early as the

United States prevalence of pediatric asthma by environmental tobacco smoke exposure, 2016–2017

Objectives We sought to update the prevalence estimates of parent-reported asthma diagnosis by Environmental Tobacco Smoke (ETS) exposure in the United States (US) pediatric population. Methods This cross-sectional study included 71,811 families with children who participated in the 2016–2017 National Survey of Children’s Health (NSCH). Weighted asthma prevalence estimates were calculated for ETS-exposed and non-exposed children. Chi-square analysis compared asthma prevalence between the two exposure groups and logistic regression analysis generated adjusted odds ratios (aORs) of asthma diagnosis by ETS exposure by sex, race/ethnicity, and household education and income level. Results Asthma prevalence estimates were significantly higher in ETS-exposed vs. non-exposed children (10.7% vs. 7.8%, p < 0.001). Children with a smoker in the house are 30% more likely to have an asthma diagnosis vs. children with no smokers in the house (aOR 1.29, 95% Confidence Interval [CI] 1.09–1.52). Significant predictors for ETS exposure included < high school education and lower family income. Conversely, non-Hispanic black and Hispanic children were less likely to have ETS exposure vs. non-Hispanic white children. Conclusions ETS exposure is a significant risk factor for asthma in the US pediatric population. Smoking cessation initiatives targeting non-Hispanic white parents from lower socioeconomic may improve children’s chronic pulmonary health risk.

Asthma.

Asthma is the most common chronic respiratory disease of childhood, a leading cause of emergency department visits, and 1 of the top 3 indications for hospitalization in children. Despite advances in the management of pediatric asthma, significant disparities in care and outcomes persist. To bridge these gaps, we must embrace the concept of asthma care across the continuum and extend our reach beyond the immediate patient-provider visit.After completing this article, readers should be able to:Asthma is defined by episodic and reversible airway constriction and inflammation in response to infection, environmental allergens, and irritants. It is a complex, multifactorial, and immune-mediated process that presents with various clinical phenotypes.Despite novel treatments and guideline-based care, asthma remains a significant public health problem. Medical care, missed school, and missed work related to asthma continue to burden our communities, costing more than $80 billion each year. (1) Furthermore, asthma disproportionately affects minorities and socioeconomically disadvantaged children. (2) Black children have the highest asthma morbidity and mortality rates of any US group, with twice the emergency department (ED) visit/hospitalization rate and 9 times the mortality rate as white children. (3)(4)(5)In 2012, the President’s Task Force on Environmental Health Risks and Safety Risks to Children commissioned a cabinet-level, multiagency group to address overall asthma morbidity and its racial and ethnic disparities. (6) The group chose 4 integrated strategies.Asthma affects 1 in 12 US children aged 0 through 17 years. (3) After decades of increases, the prevalence of asthma in this group plateaued between 2010 and 2012, (2) decreased in 2013 from 9.3% in 2012 to 8.3%, and remained stable through 2016. (2)(3) In contrast, pediatric asthma prevalence in black children increased between 2001 and 2009, leveling off by 2013. (2) In 2016, asthma prevalence in black children rose sharply to 15.7% (a 2.3% increase from 2014 and 2015), twice that of white children. (3) This rate surpassed that of Puerto Rican children, who previously had the highest prevalence of asthma of all US children. (3) The prevalence of asthma in children in poverty did not decrease between 2001 and 2013 and remained high in 2016 (10.5%). (2)(3)Asthma exacerbation is a leading cause of (ED) visits (7) and 1 of the top 3 indications for hospitalization in children. (8) Comparing asthma outcomes between subgroups, an at-risk rate (ARR) is preferred over the traditional population-based rate (PBR). (9) An ARR is the number of children with the outcome (eg, asthma hospitalization or death) divided by the total number of children at risk for that outcome (those with asthma). Conversely, a PBR is the number of children with the asthma outcome divided by the total population. PBRs measure the overall burden of disease in a particular population or subgroup, whereas an ARR accounts for differences in prevalence between subgroups to describe disparities.(4) Between 2001 and 2010, ARRs for black and white children revealed a decrease in racial disparities for ED visit and hospitalization rates and no change in death rate due to asthma. (4) It is important to note, however, that ARRs do not account for differences in underlying asthma severity. A 2013 analysis of hospitalizations for chronic conditions in the Pediatric Health Information System database found that black children had the highest asthma readmission rate (21.4%) of any race or ethnicity. (10) Finally, because ARRs rely on prevalence estimates, any undercounting of

The association between pediatric asthma and body composition in Lima, Peru

TPS 752: Respiratory effects and allergies, Exhibition Hall, Ground floor, August 27, 2019, 3:00 PM - 4:30 PM Background: The link between adiposity and asthma development is of growing concern in low-and-middle-income countries where pediatric asthma prevalence is high and childhood obesity rates are rising. Some adiposity phenotypes and body composition measures may be more strongly associated with asthma than others, yet most existing studies have focused only on body mass index (BMI) in adults. Our objective was to explore the association of body composition measurements with current asthma in children in a low-resource, urban setting in Peru. Methods: We evaluated 447 children aged 9-19 years, with persistent asthma over a period of 12 months. Asthma Control Test (ACT) was administered monthly. Uncontrolled asthma was defined as having an ACT ≤ 19. We measured adiposity at baseline using objective measures: body mass index (BMI), body fat percentage (BF), calculated lean muscle (LM), and calculated fat mass (FM) using bioimpedance (BIA) with the TANITA device. We used multiple logistic regression to analyze associations between body composition measures and asthma control, adjusted by sex, age, SES, site, baseline lung function, and temperature. Results: At baseline, 13% of asthmatics had uncontrolled asthma. In bivariate analyses, we measured greater adiposity for children with uncontrolled vs. controlled asthma for all body composition measurements; however, results were only significant for BF measurements (mean [sd]: 28% [8.9] vs. 26% [9.6], p<0.05). In multivariable analyses, an increase in adiposity was not significantly associated with any measures of uncontrolled asthma. Conclusions: In longitudinal analysis, we found no association between asthma control and body composition variables. These results highlight the importance of examining the relationship between multiple adiposity measures and controlled asthma.

Stress reduction intervention with mothers of children/adolescents with asthma: a randomized controlled study in Brazil

Brazil has a high prevalence of pediatric asthma, which can be a stressor to parents/caretakers. Researchers aimed to assesses the efficacy of a stress reduction intervention for mothers of children/adolescents with asthma through a randomized controlled study. Stress, anxiety, and depression were evaluated in three moments. The intervention group (n = 20), entailed 5-weekly sessions; the control group (n =34) had waiting list format. There was a significant decrease in stress, anxiety, and depression in the intervention group. This study indicates that the intervention directed to mothers of children/adolescents with asthma was efficient not only in reducing stress but also anxiety and depression reduction.

Association of global trends of national tobacco smoking rates with prevalence of pediatric asthma and allergy

Association of global trends of national tobacco smoking rates with prevalence of pediatric asthma and allergy

Prescription Patterns and Burden of Pediatric Asthma in Korea.

PurposeThis study aimed to estimate the prevalence, prescription pattern and burden of pediatric asthma in Korea by analyzing the National Health Insurance (NHI) claims data.MethodsWe retrospectively analyzed the insurance claim records from the Korean NHI claims database from January 2010 to December 2014. Asthmatic patients were defined as children younger than 18 years, with appropriate 10th Revision of the International Classification of Diseases codes (J45 or J46) and a prescription for 1 or more asthma maintenance medications at the same date. Hospitalization and emergency department visits for asthma were defined as use of short-acting beta2-agonists during hospital visits among asthmatic patients.ResultsThere were 1,172,807 asthmatic children in 2010, which increased steadily to 1,590,228 in 2014 in Korea. The prevalence showed an increasing trend annually for all ages. The mean prevalence by age in those older than 2 years decreased during the study period (from 39.4% in the 2–3 year age group to 2.6% in the 15–18 year age group). In an outpatient prescription, leukotriene receptor antagonists were the most commonly prescribed medication for all ages. Patients older than 6 years for whom inhaled corticosteroids were prescribed comprised less than 15% of asthmatic patients. The total direct medical cost for asthma between 2010 and 2014 ranged from $376 to $483 million. Asthma-related medical cost per person reached its peak in $366 in 2011 and decreased to $275 in 2014.ConclusionsThe prevalence of pediatric asthma increased annually and decreased with age. Individual cost of asthma showed a decreasing trend in Korean children.

Cost effectiveness of vitamin c supplementation for pregnant smokers to improve offspring lung function at birth and reduce childhood wheeze/asthma.

To determine the implications of supplemental vitamin C for pregnant tobacco smokers and its effects on the prevalence of pediatric asthma, asthma-related mortality, and associated costs. A decision-analytic model built via TreeAge compared the outcome of asthma in a theoretical annual cohort of 480,000 children born to pregnant smokers through 18 years of life. Vitamin C supplementation (500 mg/day) with a standard prenatal vitamin was compared to a prenatal vitamin (60 mg/day). Model inputs were derived from the literature. Deterministic and probabilistic sensitivity analyses assessed the impact of assumptions. Additional vitamin C during pregnancy would prevent 1637 cases of asthma at the age of 18 per birth cohort of pregnant smokers. Vitamin C would reduce asthma-related childhood deaths and save $31,420,800 in societal costs over 18 years per birth cohort. Vitamin C supplementation in pregnant smokers is a safe and inexpensive intervention that may reduce the economic burden of pediatric asthma.

Association between social economic status and asthma in Korean children: An analysis of the Fifth Korea National Health and Nutrition Examination Survey (2010–2012)

Purpose: Asthma is one of the most common chronic conditions, and its prevalence has been increasing in recent decades. Social economic status is a well-known risk factor for asthma. This study was performed to investigate the relationship between social eco nomic status and asthma in Korean children. Methods: Data were acquired from 4,397 children, aged under 18 years who participated in the Fifth Korea National Health and Nu trition Examination Surveys, which was conducted from 2010 to 2012. The presence of asthma was based on self-reported, physi cian-diagnosed asthma in the Health Interview Surveys. Results: The prevalence of pediatric asthma was 5.3%, while the prevalence of atopic dermatitis in children was 14.0%. In univariate analysis, asthmatic children tended to be male, to be older, to have asthmatic mothers, to suffer from atopic dermatitis and to live in urban areas (P<0.05). The parents’ marital status, employment status, education level, and the number of household members were not associated with pediatric asthma. In logistic regression analysis, older age, male sex, maternal asthma, pediatric atopic dermati tis, and urban residence were associated with a higher prevalence of childhood asthma (P<0.01). Conclusion: Socioeconomic status was not an important risk factor for asthma in Korean children in our study. It is conceivable that socioeconomic factor could affect the asthma prevalence in a different manner in each country. Further studies are warranted to ex plore mechanisms responsible for the association between socioeconomic status and asthma in children. (Allergy Asthma Respir Dis 2018;6:90-96)

Urban Decay and Pediatric Asthma Prevalence in Memphis, Tennessee: Urban Data Integration for Efficient Population Health Surveillance

In this paper, we investigate the relationships between dwelling conditions and pediatric asthma prevalence, merging multiple data sources to unpack disproportionate pediatric asthma prevalence in Memphis, TN, USA. Using 32 097 pediatric asthma encounter data from a children’s hospital, we map the patient distributions in Memphis. Connecting these data with 244 000 property quality data and census data, we show that pediatric asthma is disproportionately prevalent in the bad quality neighborhoods, even after controlling for ethnicity and poverty level. Furthermore, we show that the neighborhood inequality has a more negative effect than the overall neighborhood degeneration. Our novel data integration provides a unique opportunity to directly test the relationship between residential qualities and asthma prevalences at the macro-level, and to the best of our knowledge, this study is the first study that investigates the association between the detailed property quality and pediatric asthma with a relatively large sample size. Moreover, directly connecting health outcomes with the detailed housing quality data enables us to unpack how the inequality in living conditions yields disproportionate public health outcome distributions. To further improve public health decision making, the health issue should be approached with a more holistic view with taking into account environmental, residential, and social conditions. Integrating multiple data sources helps us not only discover the hidden links between quality of housing and childhood asthma in an urban community but also provide more efficient health surveillance guidelines to identify the population at risk. We show that neighborhood blight and inequality are closely associated with childhood asthma and other consecutive health problems, and therefore, any effective health intervention should also consider consolidation of housing policies and procedures. In addition, the detailed neighborhood level data helps us to reveal the pathways of social inequalities to health disparities and improve the public health through a properly designed surveillance system.

Prevalence of Pediatric Asthma Risk in Santo Domingo, Dominican Republic

BackgroundEarly detection and treatment of pediatric asthma could reduce morbidity and lessen burden on society. Currently there is no known research on the prevalence of pediatric asthma in the Dominican Republic (DR) and no known asthma risk assessment tool for one-time encounters in a fast-paced clinic. ObjectivesTo pilot a streamlined version of previously validated screening tools to estimate the prevalence of pediatric asthma risk in Santo Domingo Norte, DR. MethodsA combined asthma questionnaire and clinical assessment tool was developed and administered to patients aged 2-12 years. FindingsWe found that 25.7% of the 74 study participants were categorized as probable asthma, 21.6% were at high risk for asthma, 14.9% elevated risk, and 37.8% not at risk. ConclusionIf the prevalence of 25.7% is representative of the DR as a whole, the DR would have one of the highest national rates in Latin America. The study assessment tool was convenient to use, but tool validation is needed.