Abstract
Objectives
Air pollution is a leading environmental risk, and socioeconomic status (SES) is postulated as an effect modifier, especially in children. There is a growing interest in exploring this modifier. The present manuscript reviews SES as an effect modifier in children’s respiratory health.
Methods
A search in the PubMed and SCOPUS databases was conducted in September 2017 to identify studies with the inclusion criteria of being centred on children, respiratory outcomes, air pollutants and SES measurement.
Results
A total of 17 studies were included. Twelve used single SES variables, and the remaining studies included composite SES indices. Household income (9) and parental education (8) were frequently evaluated. The significance of the effect modifier was found in nine studies that demonstrated a higher risk for individuals living in a lower SES. Sources of heterogeneity included SES measurement, health outcomes and geographical aggregation.
Conclusions
The results suggest a higher modification in the effect of SES, generally indicating greater risk for children in lower SES. Children’s characteristics need to be more carefully theorized and measured in this area, including the use of transdisciplinary approaches.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Alwahaibi A, Zeka A (2016) Respiratory and allergic health effects in a young population in proximity of a major industrial park in Oman. J Epidemiol Community Health 70:174–180. https://doi.org/10.1136/jech-2015-205609
Barraza-Villarreal A, Sunyer J, Hernandez-Cadena L et al (2008) Air pollution, airway inflammation, and lung function in a cohort study of Mexico City schoolchildren. Environ Health Perspect 6:832–838. https://doi.org/10.1289/ehp.10926
Bell ML, Ebisu K (2012) Environmental inequality in exposures to airborne particulate matter components in the United States. Environ Health Perspect 120:1699–1704. https://doi.org/10.1289/ehp.1205201
Benmarhnia T, Rey L, Cartier Y et al (2014) Addressing equity in intervention to reduce air pollution in urban areas: a systematic review. Int J Public Health 59:933–944. https://doi.org/10.1007/s00038-014-0608-0
Burra TA, Moineddin R, Agha MM et al (2009) Social disadvantage, air pollution, and asthma physician visits in Toronto, Canada. Environ Res 109:567–574. https://doi.org/10.1016/j.envres.2009.03.004
Cakmak S, Dales R, Judek S (2006) Do gender, education, and income modify the effect of air pollution gases on cardiac disease? J Occup Environ Med 48:89–94. https://doi.org/10.1097/01.jom.0000184878.11956.4b
Cakmak S, Hebbern C, Cakmak JD et al (2016) The modifying effect of socioeconomic status on the relationship between traffic, air pollution and respiratory health in elementary schoolchildren. J Environ Manage 177:1–8. https://doi.org/10.1016/j.jenvman.2016.03.051
Campbell RT (1983) Status attainment research: end or the beginning or beginning of the end? Sociol Educ 56:47–62. https://doi.org/10.2307/2112302
Clark NA, Demers PA, Karr CJ et al (2010) Effect of early life exposure to air pollution on development of childhood asthma. Environ Health Perspect 118:284–290. https://doi.org/10.1289/ehp.0900916
Clougherty JE, Kubzansky LD (2009) A framework for examining social stress and susceptibility to air pollution in respiratory health. Environ Health Perspect 117:1351–1358. https://doi.org/10.1289/ehp.0900612
Corburn J, Osleeb J, Porter M (2006) Urban asthma and the neighborhood environment in New York City. Health Place 12:167–179. https://doi.org/10.1016/j.healthplace.2004.11.002
Corvalán C, Amigo H, Bustos P et al (2005) Socioeconomic risk factors for asthma in Chilean young adults. Am J Public Health 95:1375–1381. https://doi.org/10.2105/AJPH.2004.048967
Delfino RJ, Chang J, Wu J et al (2009) Repeated hospital encounters for asthma in children and exposure to traffic-related air pollution near the home. Ann Allergy Asthma Immunol 102:138–144. https://doi.org/10.1016/S1081-1206(10)60244-X
Ebisu K, Holford TR, Belanger KD et al (2011) Urban land-use and respiratory symptoms in infants. Environ Res 111:677–684. https://doi.org/10.1016/j.envres.2011.04.004
Evans GW (2006) Child development and the physical environment. Annu Rev Psychol 57:423–4521. https://doi.org/10.1146/annurev.psych.57.102904.190057
Evans GW, Kantrowitz E (2002) Socioeconomic status and health: the potential role of environmental risk exposure. Annu Rev Public Health 23:303–331. https://doi.org/10.1146/annurev.publhealth.23.112001.112349
Gauderman WJ, Gilliland GF, Berhane K et al (2002) Association between air pollution and lung function growth in southern California children: results from a second cohort. Am J Respir Crit Care Med 166:76–84. https://doi.org/10.1164/rccm.2111021
Grineski SE, Staniswalis JG, Peng Y et al (2010) Children’s asthma hospitalizations and relative risk due to nitrogen dioxide (NO2): effect modification by race, ethnicity, and insurance status. Environ Res 110:178–188. https://doi.org/10.1016/j.envres.2009.10.012
Hernández-Cadena L, Holguin F, Barraza-Villarreal A et al (2009) Increased levels of outdoor air pollutants are associated with reduced bronchodilation in children with asthma. Chest 136:1529–1536. https://doi.org/10.1378/chest.08-1463
Hoffmann B, Kolahgar B, Rauchfuss K et al (2009) Childhood social position and associations between environmental exposures and health outcomes. Int J Hyg Environ Health 212:146–156. https://doi.org/10.1016/j.ijheh.2008.04.002
Holifield R, Porter M, Walker G (2009) Introduction Spaces of environmental justice: frameworks for critical engagement. Antipode 41:591–612. https://doi.org/10.1111/j.1467-8330.2009.00690.x
Hornberg C, Pauli A (2007) Child poverty and environmental justice. Int J Hyg Environ Health 210:571–580. https://doi.org/10.1016/j.ijheh.2007.07.006
Houweling TA, Kunst AE, Mackenbach JP (2003) Measuring health inequality among children in developing countries: Does the choice of the indicator of economic status matter? Int J Equity Health 2:1–12. https://doi.org/10.1186/1475-9276-2-8
Kassomenos PA, Vardoulakis S, Chaloulakou C et al (2014) Study of PM10 and PM2.5 levels in three European cities: analysis of intra and inter urban variations. Atmos Environ 87:153–163. https://doi.org/10.1016/j.atmosenv.2014.01.004
Kessler R (2014) Air of danger. Nature 509(7502):62–63. https://doi.org/10.1038/509S62a
Lee JW, Marmot M (2005) Social determinants of health inequalities. Lancet 365:1099–1104. https://doi.org/10.1016/S0140-6736(05)71146-6
Lee JT, Son JY, Kim H et al (2006) Effect of air pollution on asthma-related hospital admissions for children by socioeconomic status associated with area of residence. Arch Environ Occup Health 61:123–130. https://doi.org/10.3200/AEOH.61.3.123-130
Lin M, Chen Y, Villeneuve PJ et al (2004) Gaseous air pollutants and asthma hospitalization of children with low household income in Vancouver, British Columbia, Canada. Am J Epidemiol 159:294–303. https://doi.org/10.1093/aje/kwh043
Lin S, Liu X, Le LH et al (2008) Chronic exposure to ambient ozone and asthma hospital admissions among children. Environ Health Perspect 116:1725–1730. https://doi.org/10.1289/ehp.11184
Lippmann M, Chen LC, Gordon T et al (2013) National Particle Component Toxicity (NPACT) Initiative: integrated epidemiologic and toxicologic studies of the health effects of particulate matter components. Res Report Health Eff Inst 177:5–13
Lothrop N, Hussaini K, Billheimer D et al (2017) Community-level characteristics and environmental factors of child respiratory illnesses in Southern Arizona. BMC Public Health 17:516. https://doi.org/10.1186/s12889-017-4424-3
Lynch JW, Smith GD, Kaplan GA et al (2000) Income inequality and mortality: importance to health of individual income, psychosocial environment, or material conditions. BMJ 320:1200–1204. https://doi.org/10.1136/bmj.320.7243.1200
Maantay J (2007) Asthma and air pollution in the Bronx: methodological and data considerations in using GIS for environmental justice and health research. Health Place 13:32–56. https://doi.org/10.1016/j.healthplace.2005.09.009
Makri A, Goveia M, Balbus J et al (2004) Children’s susceptibility to chemicals: a review by developmental stage. J Toxicol Environ Health B Crit Rev 7:417–435. https://doi.org/10.1080/10937400490512465
Martenies SE, Milando CW, Williams GO et al (2017) Disease and health inequalities attributable to air pollutant exposure in Detroit, Michigan. Int J Environ Res Public Health 14:1243. https://doi.org/10.3390/ijerph14101243
Oakes JM, Rossi PH (2003) The measurement of SES in health research: current practice and steps toward a new approach. Soc Sci Med 56:769–784. https://doi.org/10.1016/S0277-9536(02)00073-4
O’Lenick CR, Chang HH, Kramer MR et al (2017a) Ozone and childhood respiratory disease in three US cities: evaluation of effect measure modification by neighborhood socioeconomic status using a Bayesian hierarchical approach. Environ Health 16:1–15. https://doi.org/10.1186/s12940-017-0244-2
O’Lenick CR, Winquist A, Mulholland JA et al (2017b) Assessment of neighborhood-level socioeconomic status as a modifier of air pollution–asthma associations among children in Atlanta. J Epidemiol Community Health 71:129–136. https://doi.org/10.1136/jech-2015-206530
Organization for Economic Co-operation and Development (2016) OECD: the economic consequences of outdoor air pollution. OECD, Paris. https://doi.org/10.1787/9789264257474-en
Ostro B, Roth L, Malig B et al (2009) The effects of fine particle components on respiratory hospital admissions in children. Environ Health Perspect 117:475–480. https://doi.org/10.1289/ehp.11848
Peng RD, Bell ML, Geyh AS et al (2009) Emergency admission for cardiovascular and respiratory diseases and the chemical composition of fine particle air pollution. Environ Health Perspect 117:957–963. https://doi.org/10.1289/ehp.0800185
Pratt GC, Vadali ML, Kvale DL et al (2015) Traffic, air pollution, minority and socio-economic status: addressing inequities in exposure and risk. Int J Environ Res Public Health 12:5355–5372. https://doi.org/10.3390/ijerph120505355
Rodríguez-Villamizar LA, Berney C, Villa-Roel C et al (2016) The role of socioeconomic position as an effect-modifier of the association between outdoor air pollution and children’s asthma exacerbations: an equity-focused systematic review. Rev Environ Health 31:297–309. https://doi.org/10.1515/reveh-2016-0005
Samoli E, Nastos PT, Paliatsos AG et al (2011) Acute effects of air pollution on pediatric asthma exacerbation: evidence of association and effect modification. Environ Res 111:418–424. https://doi.org/10.1016/j.envres.2011.01.014
Selevan SG, Kimmel CA, Mendola P (2000) Identifying critical windows of exposure for children’s health. Environ Health Perspect 108:451–455. https://doi.org/10.2307/3454536
Shankardass K, McConnell R, Jerrett M et al (2009) Parental stress increases the effect of traffic-related air pollution on childhood asthma incidence. Proc Natl Acad Sci USA 106:12406–12411. https://doi.org/10.1073/pnas.0812910106
Shmool JL, Kubzansky LD, Newman OD et al (2014) Social stressors and air pollution across New York City communities: a spatial approach for assessing correlations among multiple exposures. Environ Health 91:1–15. https://doi.org/10.1186/1476-069X-13-91
Thakur N, Oh SS, Nguyen EA et al (2013) Socioeconomic status and childhood asthma in urban minority youths. The GALA II and SAGE II studies. Am J Respir Crit Care Med 188:1202–1209. https://doi.org/10.1164/rccm.201306-1016OC
United Nations Children’s Emergency Fund (2016) Clear the Air for Children: The impact of air pollution on children. https://www.unicef.org/publications/index_92957.html. Accessed 2 Nov 2017
Uphoff E, Cabieses B, Pinart M et al (2015) A systematic review of socioeconomic position in relation to asthma and allergic diseases. Eur Respir J 46:364–374. https://doi.org/10.1183/09031936.00114514
Van Vuuren CL, Reijneveld SA, van der Wal MF et al (2014) Neighborhood socioeconomic deprivation characteristics in child (0–18 years) health studies: a review. Health Place 29:34–42. https://doi.org/10.1016/j.healthplace.2014.05.010
Vinikoor-Imler LC, Owens EO, Nichols JL et al (2014) Evaluating potential response-modifying factors for associations between ozone and health outcomes: a weight-of-evidence approach. Environ Health Perspect 122:1166–1176. https://doi.org/10.1289/ehp.1307541
Wagstaff A, Watanabe N (2003) What difference does the choice of SES make in health inequality measurement? Health Econ 12:885–890. https://doi.org/10.1002/hec.805
Wendee N (2018) Advocates for children’s health: working together to reduce harmful environmental exposures. Environ Health Perspect 126:1. https://doi.org/10.1289/EHP2423
Wilhelm M, Qian L, Ritz B (2009) Outdoor air pollution, family and neighborhood environment, and asthma in LA FANS children. Health Place 15:25–36. https://doi.org/10.1016/j.healthplace.2008.02.002
World Health Organization (2004) From theory to action: implementing the WSSD Global Initiative on Children’s Environmental Health Indicators. http://www.who.int/ceh/publications/924159188_9/en/. Accessed 22 Sep 2017
Yap PS, Gilbreath S, Garcia C et al (2013) The influence of socioeconomic markers on the association between fine particulate matter and hospital admissions for respiratory conditions among children. Am J Public Health 103:695–702. https://doi.org/10.2105/AJPH.2012.300945
Yi SJ, Shon C, Min KD et al (2017) Association between Exposure to traffic-related air pollution and prevalence of allergic diseases in children, Seoul, Korea. BioMed Res Int. https://doi.org/10.1155/2017/4216107
Zeng XW, Vivian E, Mohammed K et al (2016) Long-term ambient air pollution and lung function impairment in Chinese children from a high air pollution range area: the Seven Northeastern Cities (SNEC) study. Atmos Environ 138:144–151. https://doi.org/10.1016/j.atmosenv.2016.05.003
Acknowledgements
The authors acknowledge the work of M.Sc. Myrtha E. Reyna-Vargas who corrected the final version of this manuscript. Dalia M. Munoz-Pizza received a doctoral award from the Mexican Council for Science and Technology (CONACyT).
Funding
Consejo Nacional de Ciencia y Tecnologia (MX) CONACyT provided support with a doctoral fellowship.
Author information
Authors and Affiliations
Corresponding authors
Ethics declarations
Conflict of interest
The authors declare no conflicts of interests.
Ethical approval
Statement ethical approval was not required. The authors declare ethical responsibility. This is not published nor under consideration in any other journal. The data extracted for review have been properly cited.
Human and animal rights
This article is a review and it does not require human or animal data.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Munoz-Pizza, D.M., Villada-Canela, M., Reyna, M.A. et al. Air pollution and children’s respiratory health: a scoping review of socioeconomic status as an effect modifier. Int J Public Health 65, 649–660 (2020). https://doi.org/10.1007/s00038-020-01378-3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00038-020-01378-3