ASTHMA remains the most common chronic disease among children in the United States, affecting one in twelve, or 4.2 million children, as of 2020. A growing body of research points to the significant role of indoor environmental exposures, such as allergens from cockroaches, rodents, and pollutants from gas stoves, in worsening asthma symptoms. However, measuring these exposures at a population level has proven challenging, particularly among diverse and low-income populations.
A new study has taken an innovative step by linking electronic health records (EHRs) with geospatial data to assess the relationship between indoor home environmental exposures (IHEEs) and lung function in children with asthma. Focusing on a low-income, urban cohort, the study found that the predicted presence of cockroaches and rodents in homes was independently associated with reduced lung function, measured by forced expiratory volume (FEV1%).
Importantly, the study did not adjust for race in its models, choosing instead to include area-level indicators of structural racism, such as residential segregation. This move reflects growing concern among researchers that race-based adjustments can obscure the effects of systemic inequities in housing and healthcare access. Indeed, the results suggested that race alone explained away key neighbourhood disparities, further underscoring the influence of social and environmental determinants.
Despite limitations, such as uncertainty in predicted exposure and the absence of some indoor pollutants, the study’s scalable approach represents a promising model. By combining clinical data from EHRs with publicly available geospatial information, researchers can more feasibly investigate the environmental drivers of asthma in underrepresented and vulnerable populations.
This method offers a cost-effective, reproducible way to study place-based health disparities. As indoor allergen exposure continues to pose risks for children with asthma, especially in historically marginalised communities, such integrative approaches may be key to informing targeted interventions and improving long-term health outcomes.
Reference
Bozigar M et al. Associations between in-home environmental exposures and lung function in a safety net population of children with asthma using electronic health records and geospatial data. Ann Epidemiol. 2025;105:47-52.
