Mentoring in Patient-Oriented Research on Asthma and the Indoor Environment

新出现的数据表明，很大比例的种族和民族哮喘差异可能是 到非生物因素。重要的是，种族和民族哮喘的差异在很大程度上是由 社会经济差距。由于长期存在的住房歧视，种族和少数民族 集中在贫困社区，与哮喘相关的室内和室外暴露可能因 邻里贫困。这些暴露差异可能导致哮喘患者的表型差异。 高贫困社区与低贫困社区的居民。因此，我们假设环境和环境 暴露和哮喘表型随社区贫困而不同，而且 高贫困和低贫困社区之间的暴露情况至少部分解释了 哮喘表型。为了验证这一假设，我们将(1)检查环境暴露的变化和 低收入黑人哮喘儿童的前瞻性队列研究中的哮喘表型 谁从巴尔的摩大都市区的高贫困社区搬到低贫困社区(流动哮喘项目 (2)对300名不同种族的哮喘儿童进行横断面研究，这些儿童生活在高海拔地区。 以及德克萨斯州奥斯汀-特拉维斯县的低贫困社区。我们的具体目标是：(1)确定 (1)从高贫困社区搬到低贫困社区的影响和(2)室内和室外变化的影响 MAP中哮喘表型的暴露，以及(2)确定(1)室内和室外暴露 (2)德克萨斯州中部的社区贫困程度不同，哮喘的表型也不同。我们将招收300名儿童和 哮喘样本来自奥斯汀-特拉维斯地区奥斯汀-特拉维斯县的高贫困和低贫困社区 县哮喘研究(ATX-AS)。建立暴露与哮喘表型的邻里差异 将支持推行人口层面的战略，以减少接触，有可能导致长期 在人口层面上的好处和减少哮喘的差距。在个人层面上，应该 环境暴露的改善导致向不那么严重的哮喘表型转变，然后靶向 室内和室外暴露可以减少长期的固定梗阻和慢性梗阻的风险。 肺部疾病。这些拟议的研究将为初级临床医生提供出色的培训机会。 调查人员以及私家侦探有机会扩大她的专业知识，将户外污染暴露包括在内 和健康差距科学。

Emerging data suggest that a significant proportion of racial and ethnic asthma disparities may be attributable to non-biologic factors. Importantly, racial and ethnic asthma disparities are explained to a significant extent by socioeconomic disparities. Because of longstanding housing discrimination, racial and ethnic minorities are concentrated in poor neighborhoods, and asthma-associated indoor and outdoor exposures likely vary by neighborhood poverty. These exposure differences could lead to phenotypic differences in asthma among residents of high- vs low-poverty neighborhoods. We therefore hypothesize that both environmental exposures and asthma phenotypes covary with neighborhood poverty, and that differences in exposure profiles between high- and low-poverty neighborhoods explain, at least in part, differences in asthma phenotypes. To test this hypothesis, we will (1) examine changes in environmental exposures and asthma phenotypes among an established prospective cohort study of low-income, Black children with asthma who move from high- to low-poverty neighborhoods in the Baltimore metropolitan area (Mobility Asthma Project (MAP)); and (2) conduct a cross-sectional study of 300 ethnically diverse children with asthma who live in high- and low-poverty neighborhoods in Austin-Travis County, TX. Our specific aims are: (1) To determine the effects of (1) moving from a high- to a low-poverty neighborhood and (2) changes in indoor and outdoor exposures on asthma phenotypes in MAP, and (2) To determine whether (1) indoor and outdoor exposures and (2) asthma phenotypes vary by neighborhood poverty in Central Texas. We will enroll 300 children with asthma sampled from high- and low-poverty neighborhoods across Austin-Travis County in the Austin-Travis County Asthma Study (ATX-AS). Establishing neighborhood differences in exposures and asthma phenotypes would support the pursuit of population-level strategies to reduce exposures, potentially resulting in long-term benefits at the population level and reductions in asthma disparities. At the individual level, should improvements in environmental exposures result in a shift to a less severe asthma phenotype, then targeting indoor and outdoor exposures could mitigate the long-term risks of fixed obstruction and chronic obstructive pulmonary disease. These proposed studies will offer outstanding training opportunities for junior clinician investigators as well as an opportunity for the PI to expand her expertise to include outdoor pollution exposure and health disparities science.