The urban asthma myth

Everyone knows that asthma rates are highest among low-income urban populations, right? Turns out that conventional wisdom may just be wrong. Michael Segal MD PhD pointed me to the following LA Times article (Researchers debunk the idea that asthma is more common in inner cities)

For more than 50 years, the conventional wisdom about asthma has been that it thrives in poor, densely populated urban areas. Researchers have even gone so far as to declare an “inner-city asthma epidemic.” But they’ve never actually checked whether asthma is more common in city centers than in suburbs or rural areas.

Until now.

A study published this week in the Journal of Allergy and Clinical Immunology compared asthma rates among children in census tracts across the country and found that kids in inner-city neighborhoods were no more likely to have asthma than kids who live elsewhere.

In fact, the researchers found that medium-sized cities in the Northeast and Midwest along with suburban neighborhoods in the Northeast had higher asthma prevalence than inner-city neighborhoods in any part of the country. A child’s neighborhood type didn’t matter so much as his or her racial, ethnic and socioeconomic factors.

Puerto Rican children had the highest prevalence of asthma (19.8%) among all the racial and ethnic groups in the study, followed by African American children (17.1%). The lowest prevalence was seen among Asian American children (8.1%), non-Puerto Rican Latino children (8.8%) and white children (9.6%).

Dr. Segal adds:

It is possible that certain ethnic groups are more susceptible genetically, but as detailed at www.segal.org/asthma/ I’d bet that the differences are attributable to indoor air pollution due to scented products.  Gas stoves may be important too, but I don’t know if that correlates with race, ethnicity and socioeconomic status.  There is so much concern about “blaming the victim” that doctors are not telling people what they should be doing differently at home.

—By healthcare business consultant David E. Williams, president of Health Business Group.