The connection between social class and ill-health has been established for decades, including the early 1980s groundbreaking British study known as the Black report. This research found that the main cause of health inequalities, especially with children, was economic inequality. Almost four decades on, health and class remain inextricably linked as a new study into asthma in the U.S. demonstrates.
The new study, which comes from Johns Hopkins University School of Medicine, has found that asthma morbidity rates correlate with urban living, poverty and being African American. While the findings correlate with more asthma-related emergency room visits and hospitalizations there is no association with an increased chance of having asthma.
Commenting on the study, lead researcher Dr. Corinne Keet outlines the implications: “Our findings serve as evidence that there are differences between risk factors linked to developing asthma and those linked to making asthma worse if you already have it.”
Dr. Keet’s findings are drawn from data collated by the U.S. Centers for Medicare and Medicaid Services relating to 16,860,716 children ages 5 to 19. These children were enrolled in Medicaid in 2009 and 2010. A review of these data showed the pool of data to children who had at least one asthma-related outpatient visit over the two-year period correlated with the county they lived in and was especially high for those residing in what was classed as a poor neighborhood. A poor area was defined as a locale where at least 20 percent of households were below the federal poverty line, with a household income of less than $22,050. Such a figure places the household within the lower stratum of the working class.
Children in these areas, who were identified with asthma, were 18 to 21 percent less likely to be at risk for hospitalizations. Of these a disproportionate number were classified as African-American. The inference was that asthma related morbidity was skewed by socioeconomic, geographic and/or racial/ethnic disparities.
The research is published in the Journal of Allergy and Clinical Immunology in a paper called “Urban Residence, Neighborhood Poverty, race/ethnicity and Asthma Morbidity Among Children in Medicaid.”
