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Showing content from https://pubmed.ncbi.nlm.nih.gov/30319934/ below:

Established and Emerging Environmental Contributors to Disparities in Asthma and Chronic Obstructive Pulmonary Disease

Affiliations

• ¹ Department of Environmental Health, Boston University School of Public Health.
• ² Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health; Division of Pulmonary & Critical Care Medicine, Johns Hopkins University.
• ³ Division of Pulmonary & Critical Care Medicine, Johns Hopkins University.

• PMID: 30319934
• PMCID: PMC6178976
• DOI: 10.1007/s40471-018-0149-9

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Jonathan I Levy et al. Curr Epidemiol Rep. 2018 Jun.

• ¹ Department of Environmental Health, Boston University School of Public Health.
• ² Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health; Division of Pulmonary & Critical Care Medicine, Johns Hopkins University.
• ³ Division of Pulmonary & Critical Care Medicine, Johns Hopkins University.

• PMID: 30319934
• PMCID: PMC6178976
• DOI: 10.1007/s40471-018-0149-9

Item in Clipboard

Purpose of review: Multiple respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD), display significant socioeconomic and racial/ethnic disparities. The objective of this review is to evaluate the evidence supporting a link between disproportionate environmental exposures and these health disparities.

Recent findings: Studies suggest that various co-occurring factors related to the home environment, neighborhood environment, non-modifiable individual factors, and individual behaviors and attributes can increase or modify the risk of adverse respiratory outcomes among socioeconomically-disadvantaged and racially/ethnically diverse populations. Pollutants in the home environment, including particulate matter, nitrogen dioxide, and pesticides, are elevated among lower socioeconomic status populations and have been implicated in the development or exacerbation of respiratory-related conditions. Neighborhood crime and green space are socioeconomically patterned and linked with asthma outcomes through psychosocial pathways. Non-modifiable individual factors such as genetic predisposition cannot explain environmental health disparities but can increase susceptibility to air pollution and other stressors. Individual behaviors and attributes, including obesity and physical activity, contribute to worse outcomes among those with asthma or COPD.

Summary: The root causes of these multifactorial exposures are complex, but many likely stem from economic forces and racial/ethnic and economic segregation that influence the home environment, neighborhood environment, and access to healthy foods and consumer products. Critical research needs include investigations that characterize exposure to and health implications of numerous stressors simultaneously, both to guard against potential confounding in epidemiological investigations and to consider the cumulative impact of multiple elevated environmental exposures and sociodemographic stressors on health disparities.

Keywords: asthma; chronic obstructive pulmonary disease; disparities; environment; housing; neighborhood.

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Conceptual diagram indicating the contributions…

Conceptual diagram indicating the contributions of four domains – the home environment, the…

Conceptual diagram indicating the contributions of four domains – the home environment, the neighborhood environment, non-modifiable individual factors, and individual behaviors and attributes – to environmental health disparities for respiratory outcomes.

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