Environmental risk factors for childhood asthma across multiple settings
Asthma is determined by both genetic and environmental factors, yet there is less research that clearly defines and measures different environments in which children spend most of their time. This study examines the association between children's environments (physical and social) and asthma across diverse settings. The study uses data from the National Health and Nutrition Examination Survey collected between 2003 and 2010, the Early Childhood Longitudinal Study-Birth Cohort, and the Early Childhood Longitudinal Study-Kindergarten Cohort 2010-2011 to help fill this gap. The key findings are: (1) young children with asthma are more likely to have elevated lead, although this association is explained by other sociodemographic factors; (2) children living in older homes are at higher risk for elevated lead; (3) for the poorest children, lower maternal education and health insurance predicts elevated lead; (4) preschool children in Head Start are at greater risk of asthma; (5) the effect of child care arrangement is only significantly associated with asthma for low-income children; (6) Kindergarten children attending poorer-quality schools have higher risk of asthma by first grade; and (7) attendance in center-based care prior to school entry, in addition to school-level effects, predicts increased risk of asthma for school-aged children. Disadvantaged children may be restricted to interact in lower quality physical and social environments across multiple settings, which places them at greater vulnerability of poor health. Future research should consider how multiple environmental risk factors impact children's health as they transition to different settings over time rather than focusing on the impact of a single environment.