The effect of a housing mobility program on environmental exposures and asthma morbidity among low-income minority children

住房流动计划对低收入少数族裔儿童的环境暴露和哮喘发病率的影响

• 批准号: 10469499
• 负责人: Corinne Keet
• 金额: $ 64.33万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-03-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10469499
• 关键词: Address; Adult; Allergens; Asthma; Baltimore; Birth; Child; Childhood Asthma; Communities; Data; Discrimination; Enrollment; Environmental Exposure; Exposure to; Follow-Up Studies; Growth; Home; Housing; Intervention; Life Expectancy; Long-Term Effects; Low income; Measures; Mediating; Medicaid; Morbidity - disease rate; Natural History; Neighborhoods; Outcome; Parents; Participant; Plant Roots; Policies; Pollution; Positioning Attribute; Poverty; Prospective cohort study; Psychosocial Stress; Public Health; Role; Stress; Symptoms; Time; Urban Population; Ursidae Family; base; burden of illness; caregiver stress; cohort; development policy; ethnic minority population; family support; follow-up; improved; indoor exposure; inner city; lung health; minority children; mouse allergen; poor communities; programs; pulmonary function; stressor; therapy design; tool; urban children; urban setting

Children living in poor-urban neighborhoods bear a high burden of asthma morbidity, and there is strong evidence that housing-related environmental exposures such as pest allergens are a major driver of this excess asthma morbidity. Historic residential discrimination together with systemic disinvestment in neighborhoods have contributed to poor neighborhood and housing conditions, which make successful mitigation of housing-related exposures difficult, and in many cases, impossible. In contrast, housing mobility programs, where families are supported in moving to less segregated communities, may address the root- causes of the exposures that drive asthma disparities, while also serving as a tool by which we can parse the role of various housing and neighborhood exposures and understand their long-term effects on asthma. In our Mobility Asthma Project (MAP, R01 ES026170-05), children with asthma are followed before and after moving from high-poverty segregated neighborhoods to low-poverty neighborhoods. We have found, so far, that with moving, allergen levels and asthma outcomes are markedly reduced. This suggests that housing policy may be a tool to reduce asthma disparities. However, while these initial findings strongly support the benefit of housing mobility programs on short-term asthma outcomes, additional questions have emerged which can only be answered by follow-up of this unique cohort. Our aims here are (1) To compare long-term (4-7 years) asthma morbidity and home exposures between low-income, minority children with asthma who move to low-poverty neighborhoods with similar children living in high-poverty neighborhoods, (2) To determine if moving from a high- to a low-poverty neighborhood is associated with improved lung function growth among the original MAP participants by repeatedly assessing lung function up to 4-7 years post-move and comparing their lung function trajectories with a similar population from the URECA cohort and (3) To examine the role of stress, measured by: a) exposure to neighborhood stressors, b) parental/caregiver stress, and c) child stress in the relationships between indoor exposures, moving, and asthma morbidity and lung function. The proposed MAP Follow-Up Study is poised to advance our understanding of the long-term effects of living in poor quality housing in high poverty neighborhoods on asthma and lung function growth and directly inform the development of policy- oriented interventions, such as expansion of housing mobility programs, which show great promise for reducing the disproportionate burden of asthma among minority children with asthma.

生活在城市贫困社区的儿童承受着很高的哮喘发病率负担