Division of Pediatric Pulmonology, Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY.
Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
J Allergy Clin Immunol. 2024 Nov;154(5):1159-1168. doi: 10.1016/j.jaci.2024.06.020. Epub 2024 Jul 9.
The discriminatory and racist policy of historical redlining in the United States during the 1930s played a role in perpetuating contemporary environmental health disparities.
Our objectives were to determine associations between home and school pollutant exposure (fine particulate matter [PM], NO) and respiratory outcomes (Composite Asthma Severity Index, lung function) among school-aged children with asthma and examine whether associations differed between children who resided and/or attended school in historically redlined compared to non-redlined neighborhoods.
Children ages 6 to 17 with moderate-to-severe asthma (N = 240) from 9 US cities were included. Combined home and school exposure to PM and NO was calculated based on geospatially assessed monthly averaged outdoor pollutant concentrations. Repeated measures of Composite Asthma Severity Index and lung function were collected.
Overall, 37.5% of children resided and/or attended schools in historically redlined neighborhoods. Children in historically redlined neighborhoods had greater exposure to NO (median: 15.4 vs 12.1 parts per billion) and closer distance to a highway (median: 0.86 vs 1.23 km), compared to those in non-redlined neighborhoods (P < .01). Overall, PM was not associated with asthma severity or lung function. However, among children in redlined neighborhoods, higher PM was associated with worse asthma severity (P < .005). No association was observed between pollutants and lung function or asthma severity among children in non-redlined neighborhoods (P > .005).
Our findings highlight the significance of historical redlining and current environmental health disparities among school-aged children with asthma, specifically, the environmental injustice of PM exposure and its associations with respiratory health.
20 世纪 30 年代美国历史上的歧视性和种族主义的红线政策在延续当代环境健康差距方面发挥了作用。
我们的目的是确定家庭和学校污染物暴露（细颗粒物[PM]、NO）与哮喘儿童呼吸结局（综合哮喘严重程度指数、肺功能）之间的关系，并检验这些关系在居住和/或就读于历史上被红线划定的社区与非红线划定社区的儿童之间是否存在差异。
来自 9 个美国城市的 240 名 6 至 17 岁的中重度哮喘儿童参与了该研究。根据地理空间评估的每月平均室外污染物浓度，计算了家庭和学校的 PM 和 NO 综合暴露。收集了综合哮喘严重程度指数和肺功能的重复测量值。
总体而言，37.5%的儿童居住和/或就读于历史上被红线划定的社区。与非红线划定社区的儿童相比，居住在历史上被红线划定的社区的儿童的 NO 暴露更高（中位数：15.4 与 12.1 皮克/十亿），距离高速公路更近（中位数：0.86 与 1.23 公里）（P<0.01）。总体而言，PM 与哮喘严重程度或肺功能无关。然而，在居住在红线划定社区的儿童中，较高的 PM 与更严重的哮喘严重程度相关（P<0.005）。在非红线划定社区的儿童中，未观察到污染物与肺功能或哮喘严重程度之间存在关联（P>0.005）。
我们的研究结果强调了历史红线和哮喘儿童当前环境健康差距的重要性，特别是 PM 暴露的环境不公平及其与呼吸健康的关联。
