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The Role of Housing Type and Housing Quality in Urban Children with Asthma

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Abstract

The goal of this study was to assess the relationship between type and quality of housing and childhood asthma in an urban community with a wide gradient of racial/ethnic, socioeconomic, and housing characteristics. A parent-report questionnaire was distributed in 26 randomly selected New York City public elementary schools. Type of housing was categorized using the participants’ addresses and the Building Information System, a publicly-accessible database from the New York City Department of Buildings. Type of housing was associated with childhood asthma with the highest prevalence of asthma found in public housing (21.8%). Residents of all types of private housing had lower odds of asthma than children living in public housing. After adjusting for individual- and community-level demographic and economic factors, the relationship between housing type and childhood asthma persisted, with residents of private family homes having the lowest odds of current asthma when compared to residents of public housing (odds ratio: 0.51; 95% confidence interval, 0.22, 1.21). Factors associated with housing quality explain some of the clustering of asthma in public housing. For example, the majority (68.7%) of public housing residents reported the presence of cockroaches, compared to 21% of residents of private houses. Reported cockroaches, rats, and water leaks were also independently associated with current asthma. These findings suggest differential exposure and asthma risk by urban housing type. Interventions aimed at reducing these disparities should consider multiple aspects of the home environment, especially those that are not directly controlled by residents.

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FIGURE 1.

Abbreviations

OR:

Odds ratio

CI:

Confidence interval

ETS:

Environmental tobacco smoke

References

  1. Cummins SK, Jackson RJ. The built environment and children’s health. Pediatr Clin North Am. 2001; 48: 1241–1252.

    Article  CAS  PubMed  Google Scholar 

  2. Sloggett A, Joshi H. Higher mortality in deprived areas: community or personal disadvantage? BMJ. 1994; 309: 1470–1474.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Bashir SA. Home is where the harm is: inadequate housing as a public health crisis. Am J Public Health. 2002; 92: 733–738.

    Article  PubMed  PubMed Central  Google Scholar 

  4. MacIntyre S, Ellaway A, Cummins S. Place effects on health: how can we conceptualise, operationalise and measure them? Soc Sci Med. 2002; 55: 125–139.

    Article  PubMed  Google Scholar 

  5. Northridge ME, Sclar ED, Biswas P. Sorting out the connections between the built environment and health: a conceptual framework for navigating pathways and planning healthy cities. J Urban Health. 2003; 80: 556–568.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Vlahov D, Freudenberg N, Proietti F, et al. Urban as a determinant of health. J Urban Health. 2007; 84: 16–26.

    Article  PubMed Central  Google Scholar 

  7. New York City Housing Authority. Agency report 2003-2005. 2007:1. Available from: http://www.nyc.gov/html/nycha/downloads/pdf/agency_report_2003_2005.pdf. Accessed July 26, 2007.

  8. New York City Housing Authority. About NYCHA: Fact Sheet. Available at: http://www.nyc.gov/html/nycha/html/about/factsheet.shtml. Accessed July 26, 2007.

  9. Peters JL, Levy JI, Rogers CA, Burge HA, Spengler JD. Determinants of allergen concentrations in apartments of asthmatic children living in public housing. J Urban Health. 2007; 84: 185–197.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Hood E. Dwelling disparities: how poor housing leads to poor health. Environ Health Perspect. 2005; 113: A 310–A 317.

    Article  Google Scholar 

  11. Corburn J, Osleeb J, Porter M. Urban asthma and the neighbourhood environment in New York city. Health Place. 2006; 12: 167–179.

    Article  PubMed  Google Scholar 

  12. Litonjua AA, Carey VJ, Weiss ST, Gold DR. Race, socioeconomic factors, and area of residence are associated with asthma prevalence. Pediatr Pulmonol. 1999; 28: 394–401.

    Article  CAS  PubMed  Google Scholar 

  13. Smith LA, Hatcher-Ross JL, Wertheimer R, Kahn RS. Rethinking race/ethnicity, income, and childhood asthma: racial, ethnic disparities concentrated among the very poor. Public Health Rep. 2005; 120: 109–116.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Rauh VA, Landrigan PJ, Claudio L. Housing and health: intersection of poverty and environmental exposures. Ann NY Acad Sci. 2008; 1136: 276–288.

    Article  PubMed  Google Scholar 

  15. Evans GW. The built environment and mental health. J Urban Health. 2003; 80: 536–555.

    Article  PubMed  PubMed Central  Google Scholar 

  16. McCarthy P, Byrne D, Harrison S, Keithley J. Housing type, housing location, and mental health. Soc Psychiatry. 1985; 20: 125–130.

    Article  CAS  PubMed  Google Scholar 

  17. Rauh VA, Chew GR, Garfinkel RS. Deteriorated housing contributes to high cockroach allergen levels in inner-city households. Environ Health Perspect. 2002; 110(Suppl 2): 323–327.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Fullilove MT, Fullilove RE III. What's housing got to do with it? Am J Public Health. 2000; 90: 183–184.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Matte TD, Jacobs DE. Housing and health—current issues and implications for research and programs. J Urban Health. 2000; 77: 7–25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Srinivasan S, O'Fallon LR, Dearry A. Creating healthy communities, healthy homes, healthy people: initiating a research agenda on the built environment and public health. Am J Public Health. 2003; 93: 1446–1450.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Centers for disease control and prevention. Blood lead levels—United States, 1999–2002. MMWR Morb Mortal Wkly Rep. 2005; 54: 513–516.

    Google Scholar 

  22. Belanger K, Beckett W, Triche E, et al. Symptoms of wheeze and persistent cough in the first year of life: associations with indoor allergens, air contaminants, and maternal history of asthma. Am J Epidemiol. 2003; 158: 195–202.

    Article  PubMed  Google Scholar 

  23. Bonner S, Matte TD, Fagan J, Andreopoulos E, Evans D. Self-reported moisture or mildew in the homes of head start children with asthma is associated with greater asthma morbidity. J Urban Health. 2006; 83: 129–137.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Krieger JW, Song L, Takaro TK, Stout J. Asthma and the home environment of low-income urban children: preliminary findings from the Seattle-King County Healthy Homes project. J Urban Health. 2000; 77: 50–67.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Claudio L, Stingone JA, Godbold J. Prevalence of childhood asthma in urban communities: the impact of ethnicity and income. Ann Epidemiol. 2006; 16: 332–340.

    Article  PubMed  Google Scholar 

  26. Claudio L, Stingone JA. Improving sampling and response rates in school-based research through participatory methods. J Sch Health. 2008; 78: 445–451.

    Article  PubMed  Google Scholar 

  27. SAS Institute Inc. SAS/STAT 9.1User’s Guide. Cary, NC: SAS Institute Inc; 2004.

  28. New York City Department of Buildings. The Business Information System. Available at: http://www.nyc.gov/html/dob/html/bis/bis.shtml. Accessed September 1, 2006.

  29. New York City Building Classification System. Available at: http://nycserv.nyc.gov/nycproperty/help/hlpbldgcode.html. Accessed May 6, 2009.

  30. Diaz T, Sturm T, Matte T, et al. Medication use among children with asthma in East Harlem. Pediatrics. 2000; 105: 1188–1193.

    Article  CAS  PubMed  Google Scholar 

  31. Asher MI, Keil U, Anderson HR, et al. International study of asthma and allergies in childhood (ISAAC): rationale and methods. Eur Respir J. 1995; 8: 483–491.

    Article  CAS  PubMed  Google Scholar 

  32. Engman LH, Bornehag CG, Sundell J. How valid are parents' questionnaire responses regarding building characteristics, mouldy odour, and signs of moisture problems in Swedish homes? Scand J Public Health. 2007; 35: 125–132.

    Article  PubMed  Google Scholar 

  33. Clark NM, Brown R, Joseph CL, et al. Issues in identifying asthma and estimating prevalence in an urban school population. J Clin Epidemiol. 2002; 55: 870–881.

    Article  PubMed  Google Scholar 

  34. Chew GL, Carlton EJ, Kass D, et al. Determinants of cockroach and mouse exposure and associations with asthma in families and elderly individuals living in New York City public housing. Ann Allergy Asthma Immunol. 2006; 97: 502–513.

    Article  PubMed  Google Scholar 

  35. Hynes HP, Brugge D, Watts J, Lally J. Public health and the physical environment in Boston public housing: a community-based survey and action agenda. Planning Pract Res. 2000; 15: 31–49.

    Article  Google Scholar 

  36. Zota A, Adamkiewicz G, Levy JI, Spengler J. Ventilation in public housing: implications for indoor nitrogen dioxide concentrations. Indoor Air. 2005; 15: 393–401.

    Article  CAS  PubMed  Google Scholar 

  37. Maantay J. Zoning, equity, and public health. Am J Public Health. 2001; 91: 1033–1041.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Link BG, Phelan JC. McKeown and the idea that social conditions are fundamental causes of disease. Am J Public Health. 2002; 92: 730–732.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Evans GW, Kantrowitz E. Socioeconomic status and health: the potential role of environmental risk exposure. Annu Rev Public Health. 2002; 23: 303–331.

    Article  PubMed  Google Scholar 

  40. Chakroborty J, Zandbergen PA. Children at risk: measuring racial/ethnic disparities in potential exposure to air pollution at school and home. J Epidemiol Community Health. 2007; 61: 1074–1079.

    Article  Google Scholar 

  41. Sandel M, Wright RJ. When home is where the stress is: expanding the dimensions of housing that influence asthma morbidity. Arch Dis Child. 2006; 91: 942–948.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Oh YM, Kim YS, Yoo SH, Kim SK, Kim DS. Association between stress and asthma symptoms: a population-based study. Respirology. 2004; 9: 363–368.

    Article  PubMed  Google Scholar 

  43. Clougherty JE, Levy JI, Kubzansky LD, et al. Synergistic effects of traffic-related air pollution and exposure to violence on urban asthma etiology. Environ Health Perspect. 2007; 115: 1140–1146.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Vanderbilt D, Young R, MacDonald HZ, Grant-Knight W, Saxe G, Zuckerman B. Asthma severity and PTSD symptoms among inner city children: a pilot study. J Trauma Dissociation. 2008; 9: 191–207.

    Article  PubMed  Google Scholar 

  45. Levy JI, Welker-Hood L, Clougherty JE, Dodson RE, Steinbach S, Hynes HP. Lung function, asthma symptoms, and quality of life for children in public housing in Boston; a case-series analysis. Environ Health. 2004; 3: 13–25.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Krieger JW, Higgins DL. Housing and health: time again for public health action. Am J Public Health. 2002; 92: 758–768.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Brugge D, Vallarino J, Ascolillo L, Osgood ND, Steinbach S, Spengler J. Comparison of multiple environmental factors for asthmatic children in public housing. Indoor Air. 2003; 13: 18–27.

    Article  CAS  PubMed  Google Scholar 

  48. Kinney PL, Northridge ME, Chew GL, et al. On the front lines: an environmental asthma intervention in New York City. Am J Public Health. 2002; 92: 24–26.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Jacobs DE, Kelly T, Sobolewski J. Linking public health, housing, and indoor environmental policy: successes and challenges at local and federal agencies in the United States. Environ Health Perspect. 2007; 115: 976–982.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Grant R, Bowen S, McLean DE, Berman D, Redlener K, Redlener I. Asthma among homeless children in New York City: an update. Am J Public Health. 2007; 97: 448–450.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Sharfstein J, Sandel M, Kahn R, Bauchner H. Is child health at risk while families wait for housing vouchers? Am J Public Health. 2001; 91: 1191–1192.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

This work was supported by grants to the Mount Sinai Center for Children’s Environmental Health and Disease Prevention (NIEHS/EPA Children’s Center grants ES09584 and R827039, ES/CA12770) and by the NIEHS Short-term Training Programs (ES007298 and 5 T35 ES007269-19). Additional support was provided by the Environmental Justice and Healthy Communities Program of the Ford Foundation.

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Correspondence to Luz Claudio PhD.

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Northridge, J., Ramirez, O.F., Stingone, J.A. et al. The Role of Housing Type and Housing Quality in Urban Children with Asthma. J Urban Health 87, 211–224 (2010). https://doi.org/10.1007/s11524-009-9404-1

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  • DOI: https://doi.org/10.1007/s11524-009-9404-1

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