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Lisa Black

Asthma is a leading cause of emergency pediatric care in the U.S., accounting for over 760,000 emergency department visits and 74,000 hospitalizations annually, but complete understanding of the causes of uncontrolled asthma remains elusive. A new study, “Social Determinants of Health and At-Risk Rates for Pediatric Asthma Morbidity,” in the August 2022 Pediatrics (published online Monday, July 25) finds that two community factors—decreased educational attainment and increased violent crime—were independently associated with increased asthma morbidity. Researchers studied data from 15,492 children with asthma, ages 2-17, living in Washington, D.C., from January 2018 – December 2019 and found that living in areas with greater violent crime and less school achievement were associated with higher rates of hospitalizations and emergency department visits for asthma. Study authors indicate that there could be complex reasons behind this data. For example, violent crime can reflect toxic stress, less education can be associated with limited knowledge about health and medicine, and children in these communities may have less access to primary care. Researchers concluded these findings could help develop highly localized interventions to improve pediatric asthma in affected communities, but that more research is needed on drivers of asthma morbidity, including toxic stress, structural racism, and access to medical care.


The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.

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