New Study from the Celedón Lab Highlights Link Between Social Vulnerability/Poverty and Asthma in Puerto Rican Youth

A new study from the Celedón Laboratory for Pediatric Asthma Research in the Division of Pediatric Pulmonary Medicine at UPMC Children’s Hospital of Pittsburgh provides insights into the relationship between social vulnerability, poverty, and asthma in Puerto Rican children. The research adds to the growing body of evidence around the importance of socioeconomic and demographic factors driving rates of asthma and the severity of disease in vulnerable populations.

Celedón Lab researcher Yueh-Ying Han, PhD, was the study's first author. Franziska Rosser, MD, MPH, FAAP, collaborated on the research along with senior author Juan C. Celedón, MD, DrPH, ATSF, lab principal investigator and chief of the Division of Pediatric Pulmonary Medicine at UPMC Children’s. Dr. Celedon’s lab once again collaborated with Edna Acosta-Peréz, PhD, and Glorisa Canino, PhD, from the Behavioral Sciences Research Institute at the University of Puerto Rico.

Study Overview and Key Findings

Prior research from the Celedón Lab and others studying the condition have shown that Puerto Rican children not only have higher rates of asthma than other populations but also experience more severe symptomatic expression of the condition, with correspondingly increased rates of emergency room visits and hospitalizations, among other adverse outcomes. While asthma impacts children across various geographies and ethnicities, Puerto Rican children are disproportionately affected by the condition. They exhibit the highest prevalence rates compared to other Hispanic groups as well as non-Hispanic whites. A complex dynamic of genetic, environmental, and socioeconomic factors drives the disparity in prevalence.

For their new study, the research team analyzed data from a cohort of children aged 6 to 14 who reside in San Juan and Caguas, Puerto Rico. The analysis indicates that children living in areas with higher social vulnerability index (SVI) scores are more likely to suffer from asthma. The SVI is a measure developed by the U.S. Centers for Disease Control and Prevention that uses various socioeconomic and demographic factors to assess the resilience of communities to external stresses, such as natural disasters and disease outbreaks. It scores neighborhoods on elements like poverty, lack of access to transportation, and crowded housing to identify those most at risk.

Broadly, the team’s analysis showed that children living in areas with higher social vulnerability scores were more likely to suffer from asthma. This relationship was especially strong among children from low-income households or those experiencing perceived poverty.

The study also revealed that children from households with an annual income of less than $15,000 or those who identified as poor had significantly higher odds of having persistent or new-onset asthma. This underscores the compounded impact of economic hardship on health outcomes.

While the study did find a strong link between social vulnerability and the presence of asthma, it did not find a significant connection between social vulnerability and severe asthma exacerbations requiring emergency care or hospitalization. However, Dr. Han and colleagues note that this could be due to the limited statistical power of the analysis or the influence of factors not accounted for in their study, like housing quality and neighborhood safety.

Clinical Relevance of the Study

The research findings emphasize the need for health care providers, researchers, and policymakers to appreciate and consider how social and economic contexts affect those vulnerable to developing asthma and how these factors can, and sometimes do, affect the trajectory and outcomes for patients. Understanding the broader epidemiologic constructs of where, why, and how asthma affects population subpopulations can lead to identifying vulnerable groups and more effective, tailored interventions to reduce the prevalence of asthma disparities and improve health outcomes.

Reference

Han Y-Y, Rosser FJ, Acosta-Peréz E, Canino G, Celedón JC. Social Vulnerability Index, Poverty, and Asthma in a Prospective Study of Puerto Rican Youth. Ann Allergy Asthma Immunol. 2024 May; 132(5): 646-647.

Further Reading

Learn more about the Celedón Laboratory for Pediatric Asthma Research and the Division of Pediatric Pulmonary Medicine at UPMC Children’s Hospital of Pittsburgh.