Modifiable Risk Factors for Asthma Morbidity in Bronx Versus Other Inner-City Children

Background: Bronx children have higher asthma prevalence and asthma morbidity than other US children. Objective: To compare risk factors for asthma morbidity present in Bronx children with those of children from other US inner-city areas. Methods: Cross-sectional, multi-state study of 1772 children ages 5-11 yrs. old with persistent asthma. Parental responses to the Child Asthma Risk Assessment Tool for 265 Bronx children are compared with those of 1507 children from 7 other sites (1 Northeast, 2 South, 2 Midwest, 2 West). Results: Bronx children were significantly more likely to be sensitized to reported aeroallergens in their homes than were children from the other sites (86% vs. 58%; p < .001). More Bronx parents reported household cockroaches (65% v 20%: p < .001). mice (42% v 11% p < .001), and rats (7% v 3%; p < .001); using a gas stove to heat the home (20% v 9%; p < .001) and visible mold (48% v 25% p < .001). Bronx parents were more likely to report pessimistic beliefs about controlling asthma (63% v 26%; p < .001) and high parental stress (48% v 37%; p < .01). Conclusions: Compared with other inner-city children with asthma, Bronx children are more likely to be exposed to household aeroallergens to which they are sensitized and have poor housing conditions. Their parents are more likely to report low expectations for asthma control and high levels of psychological stress. Interventions that address these identified needs may help to reduce the disproportionate burden of asthma morbidity experienced by Bronx children.