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.

居住在贫困城市社区的儿童承担着哮喘发病率的很大负担，而且有强大的 证据表明与住房相关的环境暴露（例如害虫过敏原）是其中的主要驱动力 过度哮喘发病率。历史性的住宅歧视以及全身投资 社区为贫困的社区和住房条件做出了贡献，这使得成功 缓解与住房相关的暴露很困难，在许多情况下，不可能。相反，住房流动性 支持家庭迁移到隔离较小的社区的计划，可能会解决根源 - 驱动哮喘差异的暴露的原因，同时也是我们可以解析的工具 各种住房和邻里暴露的作用，并了解它们对哮喘的长期影响。在我们的 移动性哮喘项目（MAP，R01 ES026170-05），移动前后患有哮喘的儿童 从高贫困的隔离社区到贫困社区。到目前为止，我们已经发现 移动，过敏原水平和哮喘结果明显降低。这表明住房政策可能是 一种减少哮喘差异的工具。但是，尽管这些初步发现强烈支持住房的好处 出现在短期哮喘结果的流动性计划，出现了其他问题，只能是 通过跟进这个独特的队列来回答。我们的目的是（1）比较长期（4 - 7年）哮喘 低收入，哮喘的少数族裔儿童之间的发病率和家庭暴露 居住在高贫困社区的社区，（2）确定是否从一个 高到低贫困邻居与原始地图之间的肺功能增长的改善有关 参与者通过反复评估移动后4 - 7年的肺功能并比较其肺功能 来自尿素队列的人群相似的轨迹和（3）检查压力的作用，测量 作者：a）暴露于邻里压力源，b）父母/照顾者的压力和c）关系中的儿童压力 在室内暴露，移动和哮喘发病率和肺功能之间。提议的地图随访 研究有望促进我们对高质量住房生活的长期影响的理解 关于哮喘和肺功能增长的贫困社区，并直接告知政策的发展 - 面向导向的干预措施，例如扩大住房流动计划，这对 减轻哮喘少数族裔儿童哮喘的负担不成比例的负担。