Material Hardship and Indoor Allergen Exposure among Low-Income, Urban, Minority Children with Persistent Asthma

被引:11
作者
Jabre, Nicholas A. [1 ]
Keet, Corinne A. [2 ]
McCormack, Meredith [3 ]
Peng, Roger [4 ]
Balcer-Whaley, Susan [2 ]
Matsui, Elizabeth C. [5 ]
机构
[1] Johns Hopkins Univ, Sch Med, Eudowood Div Pediat Resp Sci, Baltimore, MD USA
[2] Johns Hopkins Univ, Div Pediat Allergy & Immunol, Sch Med, Baltimore, MD USA
[3] Johns Hopkins Univ, Div Pulm & Crit Care Med, Sch Med, Baltimore, MD USA
[4] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Biostat, Baltimore, MD USA
[5] Univ Texas Austin, Dell Med Sch, Dept Populat Hlth & Pediat, 1701 Trinity St, Austin, TX 78704 USA
基金
美国国家卫生研究院;
关键词
Material hardship; Socioeconomic status; Childhood asthma; Indoor allergens; Cockroach; INNER-CITY CHILDREN; MOUSE ALLERGEN; ENVIRONMENTAL INTERVENTION; HEALTH DISPARITIES; COCKROACH ALLERGEN; MORBIDITY; SENSITIZATION; RACE;
D O I
10.1007/s10900-020-00822-y
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Traditional measures of socioeconomic status (SES) are associated with asthma morbidity, but their specific contributions are unclear. Increased exposure to indoor allergens among low SES children is an important consideration. Material hardship, a concept describing poor access to basic goods and services, may explain the relationship between low SES and indoor allergen exposure, and thereby, the increased risk of asthma morbidity. We sought to (i) describe the specific hardships experienced by low-Income, urban, minority children with asthma and indoor allergen sensitization and (ii) determine if material hardship is associated with indoor allergen exposure in this population. We conducted a cross-sectional analysis of children undergoing the baseline assessment for a clinical trial of home environmental modification. Participants were scored in five domains of material hardship. Domain scores were assigned based on caregiver responses to a questionnaire and were summed to generate a total material hardship score. Linear regression was used to examine the relationship between material hardship scores and bedroom floor concentrations of five common indoor allergens. Participants experienced high levels of material hardship in each of the five domains, with 33% not having access to a car, 35% not being able to pay utility bills, and 28% not being able to pay rent in the past year. Each one-point increase in material hardship was associated with an increase in cockroach allergen of 16.2% (95% CI 9.4%, 24.6%) and an increase in mouse allergen of 9.4% (95% CI 1.0%, 18.5%). After adjusting for traditional measures of SES, including household income, health insurance type, caregiver education, and caregiver employment status, the association between material hardship and cockroach allergen, but not mouse allergen, remained. These data suggest that a significant proportion of families of low-income, minority children with asthma may experience material hardship, and that they may be at greater risk of cockroach allergen exposure than their peers with similar income, but without material hardship.
引用
收藏
页码:1017 / 1026
页数:10
相关论文
共 30 条
[1]   Mouse allergen is the major allergen of public health relevance in Baltimore City [J].
Ahluwalia, Sharon K. ;
Peng, Roger D. ;
Breysse, Patrick N. ;
Diette, Gregory B. ;
Curtin-Brosnan, Jean ;
Aloe, Charles ;
Matsui, Elizabeth C. .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2013, 132 (04) :830-+
[2]   Characteristics of inner-city children with life-threatening asthma [J].
Bollinger, Mary Elizabeth ;
Butz, Arlene ;
Tsoukleris, Mona ;
Lewis-Land, Cassia ;
Mudd, Shawna ;
Morphew, Tricia .
ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY, 2019, 122 (04) :381-386
[3]   Association of housing disrepair indicators with cockroach and rodent infestations in a cohort of pregnant Latina women and their children [J].
Bradman, A ;
Chevrier, J ;
Tager, I ;
Lipsett, M ;
Sedgwick, J ;
Macher, J ;
Vargas, AB ;
Cabrera, EB ;
Camacho, JM ;
Weldon, R ;
Kogut, K ;
Jewell, NP ;
Eskenazi, B .
ENVIRONMENTAL HEALTH PERSPECTIVES, 2005, 113 (12) :1795-1801
[4]   Addressing asthma health disparities: A multilevel challenge [J].
Canino, Glorisa ;
McQuaid, Elizabeth L. ;
Rand, Cynthia S. .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2009, 123 (06) :1209-1217
[5]   Income is an independent risk factor for worse asthma outcomes [J].
Cardet, Juan Carlos ;
Louisias, Margee ;
King, Tonya S. ;
Castro, Mario ;
Codispoti, Christopher D. ;
Dunn, Ryan ;
Engle, Linda ;
Giles, B. Louise ;
Holguin, Fernando ;
Lima, John J. ;
Long, Dayna ;
Lugogo, Njira ;
Nyenhuis, Sharmilee ;
Ortega, Victor E. ;
Ramratnam, Sima ;
Wechsler, Michael E. ;
Israel, Elliot ;
Phipatanakul, Wanda .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2018, 141 (02) :754-+
[6]   Asthma and ethnic minorities: socioeconomic status and beyond [J].
Forno, Erick ;
Celedon, Juan C. .
CURRENT OPINION IN ALLERGY AND CLINICAL IMMUNOLOGY, 2009, 9 (02) :154-160
[7]   Material Hardships and Health Care Utilization Among Low-Income Children with Special Health Care Needs [J].
Fuller, Anne E. ;
Brown, Nicole M. ;
Grado, Lizbeth ;
Oyeku, Suzette O. ;
Gross, Rachel S. .
ACADEMIC PEDIATRICS, 2019, 19 (07) :733-739
[8]   SENSITIZATION AND EXPOSURE TO INDOOR ALLERGENS AS RISK-FACTORS FOR ASTHMA AMONG PATIENTS PRESENTING TO HOSPITAL [J].
GELBER, LE ;
SELTZER, LH ;
BOUZOUKIS, JK ;
POLLART, SM ;
CHAPMAN, MD ;
PLATTSMILLS, TAE .
AMERICAN REVIEW OF RESPIRATORY DISEASE, 1993, 147 (03) :573-578
[9]   Sensitization and Exposure to Pets: The Effect on Asthma Morbidity in the US Population [J].
Gergen, Peter J. ;
Mitchell, Herman E. ;
Calatroni, Agustin ;
Sever, Michelle L. ;
Cohn, Richard D. ;
Salo, Paivi M. ;
Thorne, Peter S. ;
Zeldin, Darryl C. .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, 2018, 6 (01) :101-+
[10]   Reduction in mouse allergen exposure is associated with greater lung function growth [J].
Grant, Torie ;
Phipatanakul, Wanda ;
Perzanowski, Matthew ;
Balcer-Whaley, Susan ;
Peng, Roger D. ;
Curtin-Brosnan, Jean ;
Newman, Michelle ;
Cunningham, Amparito ;
Divjan, Adnan ;
Bollinger, Mary E. ;
Wise, Robert A. ;
Matsui, Elizabeth C. .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2020, 145 (02) :646-+