City Address Not the Culprit in Kids' Asthma Risk

Asthma rate in kids tied to ethnicity and household income rather than living in urban area

(RxWiki News) Worried about the effect of that smoggy city air on your child? You may be able to breathe easy. Part of the asthma rate in cities may be tied to factors other than the air.

Past research on asthma found a high rate of the disease in people who lived in cities. A new study, however, found that asthma was more common than average in black or Puerto Rican children and those who lived in lower-income neighborhoods. Living in a big city did not appear to be a contributing factor to asthma rates in kids.

"Our results highlight the changing face of pediatric asthma and suggest that living in an urban area is, by itself, not a risk factor for asthma," said lead study author Corinne A. Keet, MD, PhD, of Johns Hopkins University School of Medicine in Baltimore, MD, in a press release.

Parents should watch for the warning signs of asthma in their children, said Thomas M. Seman, MD, a pediatrician in Boston.

"If the child is coughing while playing and perhaps tiring out faster than the other children have him or her evaluated by the pediatrician," Dr. Seman told dailyRx News. "Simple testing and listening to the lungs can tell the physician if the child has asthma."

Dr. Keet and team used data on more than 23,000 children from 2009 to 2011. The children were ages 6 to 17. These researchers separated the data based on the size of the city the kids lived in, their ethnicity, their household income and whether they had asthma.

When all the factor were considered, the results showed no real difference in asthma rates between children who lived in urban areas (about 13 percent had asthma) and those who didn't live in urban areas (about 11 percent has asthma).

Ethnicity appeared to have a big impact on asthma rates in children. About 20 percent of children of Puerto Rican descent had asthma, and 17 percent of black children had it. In contrast, 10 percent of white children and 8 percent of Asian children had asthma.

A lower household income was also tied to an increased asthma risk in children. Dr. Keet and colleagues suggested that household smoking, shorter time breast feeding, premature birth, allergens like rodent and cockroach droppings, outdoor pollution like vehicle fumes and poor diet may increase asthma risk in children.

"Our findings suggest that focusing on inner cities as the epicenters of asthma may lead physicians and public health experts to overlook newly emerging 'hot zones' with high asthma rates," said study author Elizabeth C. Matsui, MD, of the Johns Hopkins University School of Medicine.

Asthma is a disease that causes difficulty breathing. It is often the result of allergies or other respiratory problems. Symptoms of asthma include wheezing, shortness of breath, coughing and chest tightness.

"For the average person without a stethoscope the wheezing of asthma is a dry cough often in spasms that can be short or long," Dr. Seman said. "Cough worsens with exposure to air pollutants, especially tobacco smoke, upper respiratory infections such as colds, strenuous activity such as running, being in cold air, drinking cold liquids and with laughing. Night time cough is also a sign of asthma, especially if the cough awakens the child. Recognizing these signs is the first step in proper treatment of asthma."

This study was published online Jan. 20 in the Journal of Allergy and Clinical Immunology.

The research was funded by grants from the National Institute of Environmental Health Sciences, the National Institute of Allergy and Infectious Diseases, the US Environmental Protection Agency and the National Cancer Institute. Dr. Keet and team disclosed no conflicts of interest.

Review Date: 
January 19, 2015