Cities' Link to Asthma Disputed by Recent Study

Challenging previous research, John Hopkins University investigators claimed race, poverty, and ethnicity — not residing in urban areas — were greater forecasters of asthma. However, they cautioned their study did not determine whether location is linked to a worsening in symptoms.

Their nationwide study, posted online in January in The Journal of Allergy and Clinical Immunology, found no significant difference between asthma’s prevalence in inner cities (12.9%) versus non-inner cities (10.6%). However, by surveying 23,065 children, they identified several risk factors including ethnicity, race, and lower income.

“Our results highlight the changing face of pediatric asthma and suggest that living in an urban area is, by itself, not a risk factor for asthma,” a pediatric allergy and asthma specialist at Johns Hopkins and the paper’s lead author, Corinne Keet, MD, PhD, said in a statement. “Instead, we see that poverty and being African American or Puerto Rican are the most potent predictors of asthma risk.”

With 39.5 million sufferers in the US — amounting to 1 in 11 children and 1 in 12 adults — complications and treatments associated with asthma carry a heavy economic burden, with the Centers for Disease Control and Prevention estimating it cost $50.1 billion annually to handle the condition.

The researchers believe their findings also underscored a shift in poverty’s influence in rural and suburban regions as well as an increase in minorities emigrating from cities.

“Our findings suggest that focusing on inner cities as the epicenters of asthma may lead physicians and public health experts to overlook newly emerging ‘hot zones’ with high asthma rates,” a pediatric asthma specialist and associate professor of pediatrics and epidemiology at the Johns Hopkins University School of Medicine and the study’s senior author, Elizabeth Matsui, MD, MHS concluded.