Public Health Question
URBAN ASTHMA IN US ADOLESCENTS: ENVIRONMENTAL INFLUENCES Environmental Factors Contributing to Elevated Asthma Prevalence among Adolescents in Urban Environments in the United States: A Review Arisha Momin The University of Georgia HPRB 5010 Dr. Proctor April 8, 2024 URBAN ASTHMA IN US ADOLESCENTS: ENVIRONMENTAL INFLUENCES 2 Table of Contents Research Question ………………………………………………………………………………………………………….. 3 INTRODUCTION ………………………………………………………………………………………………………….. 3 METHODS ……………………………………………………………………………………………………………………. 6 RESULTS ……………………………………………………………………………………………………………………… 9 Air Pollution and Socioeconomic Factors ……………………………………………………………….. 9 Exposure to Indoor Allergies ……………………………………………………………………………….. 10 Urban Heat Islands ……………………………………………………………………………………………… 10 Traffic-Related Air Pollution and Tobacco Smoke Exposure …………………………………… 11 DISCUSSION ………………………………………………………………………………………………………………. 12 Study Limitation ………………………………………………………………………………………………… 14 Solution and Policy Implications ………………………………………………………………………….. 14 CONCLUSION AND FUTURE DIRECTIONS ……………………………………………………………….. 15 REFERENCES …………………………………………………………………………………………………………….. 18 URBAN ASTHMA IN US ADOLESCENTS: ENVIRONMENTAL INFLUENCES 3 Research Question How do environmental factors contribute to elevated asthma prevalence among adolescents in urban environments in the United States? INTRODUCTION Asthma is a chronic respiratory disease that includes periodic and short episodes of wheezing, shortness of breath, chest tightness, and coughing, all caused by airway inflammation. Its complexity aligns with the subtype heterogeneity, including allergic, non-allergic, exerciseinduced bronchoconstriction, and occupational asthma, which are attributed to inherited and environmental components (Chan, Hu, Chu, & Hwang, 2019). The most common form of asthma, allergic asthma, is caused by inhaling tiny particles such as pollen, dust mites, or pet dander. Also, non-allergic asthma manifests through various factors such as stress, exercise, cold air, and pollution in the environment (Adams & Knuth, 2024). The asthma remit is not only on the physical signs but also on the individual’s social and healthcare system, as severe asthma may be life-threatening to anyone. The United States has seen variations in cases of asthma in the recent decade, with the Centers for Disease Control and Prevention (CDC) reporting a mild drop in its prevalence. As a result, even though over 25 million people are expected to be affected, including teenagers, asthma remains one of the most severe health issues (Pate et al., 2021). According to Toneweber et al. (2023), the physical aspects of asthma include missing classes, poor academic performance, and detachment from classmates Therefore, a multifaceted approach is needed to understand and manage asthma. Significant research is going on about the environmental components that promote asthma increases among teenagers in urban regions, as such environments create many health gaps that are not equal (Adams & Knuth, 2024). Urban adolescents are exposed to asthma URBAN ASTHMA IN US ADOLESCENTS: ENVIRONMENTAL INFLUENCES 4 risk factors on a unique scale. Significant air pollution, contact with indoor allergens, socioeconomic inequalities, and stress due to the urban living environment are considered such factors. Apart from the environmental aspects, the social inequalities not only make asthma more common among urban teens but also increase the complications and health care costs. Studies have shown that people coming from poor socioeconomic status’ suffer more from asthma because they do not have adequate healthcare facilities; their homes may not be well constructed, which can expose them to more environmental pollutants (Custovic, de Moira, Murray, & Simpson, 2023). The geographical aspects concern low-income urban areas, mainly those living at low altitudes, which face high rates of asthma epidemiology. These differentiations are more than simple physiological conditions; they hinder school performance and social integration as well (Toneweber et al., 2023). Through the investigation of how air pollution meets socioeconomic gaps as well as geographical settings, practical recommendations and evidencebased environmental policies can be produced to reduce the asthma burden in urban areas and improve our teenagers’ health in general. Numerous controlled studies in the field have pinpointed the adverse effects of air pollution on asthmatic patients, and it is known that air pollutants, including particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3), exacerbate asthma symptoms (Custovic et al., 2023). Allergens such as dust mites, mold, and pet dander become dangerous indoors, which is often displayed in poor housing conditions in many of the world’s largest urban areas (Jennifer et al., 2023). Inequalities in socioeconomic positioning, the lack of medical infrastructure and resources, the difficulty of controlling the symptoms of disease and toxins, and other types of dangers that result from poverty influence the prevalence of asthma (Tiotiu et al., 2020). Recent URBAN ASTHMA IN US ADOLESCENTS: ENVIRONMENTAL INFLUENCES 5 studies postulated that the low SES adolescents have more asthma cases than the higher SES adolescents. Also, the people living in low-income urban areas, most of them nearer to sea level, have higher asthma rates than their counterparts residing in higher-income areas and higher altitudes (Tiotiu et al., 2020). The prevalence of asthma is based on demographics and variations in poverty levels. According to (Pate et al., 2021), asthma prevalence differs based on demographic attributes; for example, asthma among children was 8.1%, while that of adults was 7.9%. Besides, 9.4% of the females were diagnosed with the same condition, while 6.5% of the men had the same condition. Age was an essential factor contributing to the difference in the prevalence rates between males and females (The Statistical Research Department, 2023). Nonetheless, the prevalence of asthma among children between zero to four was at its lowest, 4.0%, while it was highest among teenagers between 12 and 17 years, which was at 10.5% (Pate et al., 2021). Some of the most affected races included Blacks (10.7%), whites (8.0%), Latinx (6.5%), and individuals from other races (13.1%). The same study outlined that the prevalence of asthma-based family income
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