Child Opportunity Index at birth and asthma with recurrent exacerbations in the US ECHO program

Rachel L. Miller; Holly Schuh; Aruna Chandran; Rima Habre; Jyoti Angal; Izzuddin M. Aris; Judy L. Aschner; Casper G. Bendixsen; Jeffrey Blossom; Michelle Bosquet-Enlow; Carrie V. Breton; Carlos A. Camargo; Kecia N. Carroll; Sarah Commodore; Lisa A. Croen; Dana M. Dabelea; Sean C.L. Deoni; Assiamira Ferrara; Rebecca C. Fry; Jody M. Ganiban; Sarah D. Geiger; James E. Gern; Frank D. Gilliland; Semsa Gogcu; Diane R. Gold; Marion E. Hare; Robyn N. Harte; Tina V. Hartert; Irva Hertz-Picciotto; Alison E. Hipwell; Daniel J. Jackson; Margaret K. Karagas; Gurjit K. Khurana Hershey; Haejin Kim; Augusto A. Litonjua; Carmen J. Marsit; Cynthia T. McEvoy; Eneida A. Mendonça; Paul E. Moore; Anh P. Nguyen; Flory L. Nkoy; Thomas G. O’Connor; Emily Oken; Dennis R. Ownby; Matthew Perzanowski; Katherine Rivera-Spoljaric; Sheela Sathyanarayana; Anne Marie Singh; Joseph B. Stanford; Annemarie Stroustrup; Nissa Towe-Goodman; Veronica A. Wang; Tracey J. Woodruff; Robert O. Wright; Rosalind J. Wright; Antonella Zanobetti; Edward M. Zoratti; Christine C. Johnson; Viren D'Sa; Hans-Georg Mueller; Cristiane S. Duarte; Catherine Monk; Glorisa Canino; Jonathan Posner; Tenneill Murray; Claudia Lugo-Candelas; Anne L. Dunlop; Patricia A. Brennan; Christine Hockett; Amy Elliott; Monique M. Hedderson; John Ainsworth; Leonard B. Bacharier; Christine L.M. Joseph; Meyer Kattan; Robert F. Lemanske; Susan V. Lynch; George T. O’Connor; Carole Ober; Patrick H. Ryan; Christine M. Seroogy; Robert A. Wood; Shohreh Farzan; Deborah H. Bennett; Julie B. Schweitzer; Rebecca J. Schmidt; Janine M. LaSalle; Kate E. Keenan; Catherine J. Karr; Nicole R. Bush; Kaja Z. LeWinn; Qi Zhao; Frances Tylavsky; Christine T. Loftus; Leslie D. Leve; Jenae M. Neiderhiser; Scott T. Weiss; Eliot R. Spindel; Robert S. Tepper; Craig J. Newschaffer; Kristen Lyall; Heather E. Volk; Rebecca Landa; Sally Ozonoff; Joseph Piven; Heather Hazlett; Juhi Pandey; Robert Schultz; Steven Dager; Kelly Botteron; Daniel Messinger; Wendy Stone; Jennifer Ames; Richard K. Miller; Michele R. Hacker; Tamarra James-Todd; T. Michael O'Shea; Jean A. Frazier; Rachana Singh; Caitlin Rollins; Angela Montgomery; Ruben Vaidya; Robert M. Joseph; Lisa K. Washburn; Kelly Bear; Julie V. Rollins; Stephen R. Hooper; Genevieve Taylor; Wesley Jackson; Amanda Thompson; Julie Daniels; Michelle Hernandez; Kun Lu; Michael Msall; Madeleine Lenski; Rawad Obeid; Steven L. Pastyrnak; Elizabeth Jensen; Christina Sakai; Hudson Santos; Jean M. Kerver; Nigel Paneth; Charles J. Barone; Michael R. Elliott; Douglas M. Ruden; Chris Fussman; Julie B. Herbstman; Amy Margolis; Susan L. Schantz; Andrea Aguiar; Karen Tabb; Rita Strakovsky; Rachel Morello-Frosch; Amy Padula; Christina A. Porucznik; Angelo P. Giardino; Brent Collett; Nicole Baumann-Blackmore; Ronald Gangnon; Chris G. McKennan; Jo Wilson; Matt Altman; Stephanie L. Merhar; Gloria S. Pryhuber; Mark Hudak; Ann Marie Reynolds Lyndaker; Andrea L. Lampland; Burton Rochelson; Sophia Jan; Matthew J. Blitz; Michelle W. Katzow; Zenobia Brown; Codruta Chiuzan; Timothy Rafael; Dawnette Lewis; Natalie Meirowitz; Brenda Poindexter; Tebeb Gebretsadik; Sarah Osmundson; Jennifer K. Straughen; Amy Eapen; Andrea Cassidy-Bushrow; Ganesa Wegienka; Alex Sitarik; Audrey Urquhart; Albert Levin; Tisa Johnson-Hooper; Brent Davidson; Tengfei Ma; Emily S. Barrett; Martin J. Blaser; Maria Gloria Dominguez-Bello; Daniel B. Horton; Manuel Jimenez; Todd Rosen; Kristy Palomares; Lyndsay A. Avalos; Yeyi Zhu; Kelly J. Hunt; Roger B. Newman; Michael S. Bloom; Mallory H. Alkis; James R. Roberts; Sunni L. Mumford; Heather H. Burris; Sara B. DeMauro; Lynn M. Yee; Aaron Hamvas; Antonia F. Olidipo; Andrew S. Haddad; Lisa R. Eiland; Nicole T. Spillane; Kirin N. Suri; Stephanie A. Fisher; Jeffrey A. Goldstein; Leena B. Mithal; Raye-Ann O. DeRegnier; Nathalie L. Maitre; Ruby H.N. Nguyen; Meghan M. JaKa; Abbey C. Sidebottom; Michael J. Paidas; JoNell E. Potter; Natale Ruby; Lunthita Duthely; Arumugam Jayakumar; Karen Young; Isabel Maldonado; Meghan Miller; Jonathan L. Slaughter; Sarah A. Keim; Courtney D. Lynch; Kartik K. Venkatesh; Kristina W. Whitworth; Elaine Symanski; Thomas F. Northrup; Hector Mendez-Figueroa; Ricardo A. Mosquera; Juliette C. Madan; Debra M. MacKenzie; Johnnye L. Lewis; Brandon J. Rennie; Bennett L. Leventhal; Young Shin Kim; Somer Bishop; Sara S. Nozadi; Li Luo; Barry M. Lester; Todd Everson; Cynthia M. Loncar; Elisabeth C. McGowan; Stephen J. Sheinkopf; Brian S. Carter; Jennifer Check; Jennifer B. Helderman; Charles R. Neal; Lynne M. Smith; ECHO Cohort Consortium

doi:10.1016/j.jaci.2025.02.036

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Child Opportunity Index at birth and asthma with recurrent exacerbations in the US ECHO program

Journal article

Peer reviewed

Child Opportunity Index at birth and asthma with recurrent exacerbations in the US ECHO program

Rachel L. Miller, Holly Schuh, Aruna Chandran, Rima Habre, Jyoti Angal, Izzuddin M. Aris, Judy L. Aschner, Casper G. Bendixsen, Jeffrey Blossom, Michelle Bosquet-Enlow, …

Journal of allergy and clinical immunology, Vol.156(3), pp.627-639

2025-09-01

DOI: https://doi.org/10.1016/j.jaci.2025.02.036

PMID: 40089117

Appears in Miller School of Medicine - Latest Publications

Abstract

Asthma

child opportunity index

environmental and social determinants of asthma

incidence rates

recurrent asthma exacerbations

[Display omitted] Environmental exposures and social determinants likely influence specific childhood asthma phenotypes. We hypothesized that the Child Opportunity Index (COI) at birth, measuring multiple neighborhood opportunities, influences incidence rates (IRs) for asthma with recurrent exacerbations (ARE). We tested for COI associations with ARE IRs in 15,877 children born between 1990 and 2018 in the ECHO (Environmental Influences on Child Health Outcomes) program. Parent-reported race and ethnicity and other demographics were assessed as effect modifiers. The IRs of ARE for children born in very low COI neighborhoods was higher (IR = 10.98; 95% CI: 9.71, 12.25) than for other COI categories. Rates for non-Hispanic Black (NHB) children were significantly higher than non-Hispanic White children in every COI category. The ARE IRs for children born in very low COI neighborhoods were several-fold higher for NHB and Hispanic Black children (IR = 15.30; 95% CI: 13.10, 17.49; and IR = 18.48; 95% CI: 8.80, 28.15, respectively) when compared to White children. Adjusting for individual-level characteristics, children born in very low COI neighborhoods demonstrated an ARE IR ratio of 1.26 (95% CI: 0.99, 1.59) with a higher incidence of cases among children ages 2 to 4 years and with a parental history of asthma. Rates of ARE were higher among children born in under-resourced communities, and this relationship is strongest for young minoritized children with a parental history of asthma. Higher rates for NHB even in the highest COI categories suggest that risk associated with race persists regardless of social disadvantage.

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Title: Child Opportunity Index at birth and asthma with recurrent exacerbations in the US ECHO program
Creators: Rachel L. Miller - Icahn School of Medicine at Mount Sinai
Holly Schuh - Johns Hopkins University
Aruna Chandran - Johns Hopkins University
Rima Habre - Keck School of Medicine of University of Southern California, Los Angeles, Calif
Jyoti Angal - University of South Dakota
Izzuddin M. Aris - Harvard Medical School
Judy L. Aschner - Center for Discovery
Casper G. Bendixsen - Marshfield Clinic
Jeffrey Blossom - Harvard University
Michelle Bosquet-Enlow - Harvard Medical School
Carrie V. Breton - Keck School of Medicine of University of Southern California, Los Angeles, Calif
Carlos A. Camargo - Harvard Medical School
Kecia N. Carroll - Icahn School of Medicine at Mount Sinai
Sarah Commodore - Medical University of South Carolina
Lisa A. Croen - Kaiser Permanente
Dana M. Dabelea - University of Colorado Anschutz Medical Campus
Sean C.L. Deoni - Gates Foundation
Assiamira Ferrara - Kaiser Permanente
Rebecca C. Fry - University of North Carolina at Chapel Hill
Jody M. Ganiban - George Washington University
Sarah D. Geiger - University of Illinois Urbana-Champaign
James E. Gern - University of Wisconsin School of Medicine and Public Heath, Madison, Wis
Frank D. Gilliland - Keck School of Medicine of University of Southern California, Los Angeles, Calif
Semsa Gogcu - Wake Forest University
Diane R. Gold - Brigham and Women's Hospital
Marion E. Hare - University of Tennessee Health Science Center
Robyn N. Harte - Colorado School of Public Health
Tina V. Hartert - Vanderbilt University Medical Center
Irva Hertz-Picciotto - University of California, Davis
Alison E. Hipwell - University of Pittsburgh
Daniel J. Jackson - University of Wisconsin School of Medicine and Public Heath, Madison, Wis
Margaret K. Karagas - Geisel School of Medicine at Dartmouth, Hanover, NH
Gurjit K. Khurana Hershey - University of Cincinnati
Haejin Kim - Henry Ford Health, Detroit, Mich
Augusto A. Litonjua - University of Rochester Medical Center
Carmen J. Marsit - Emory University
Cynthia T. McEvoy - University of Portland
Eneida A. Mendonça - University of Cincinnati
Paul E. Moore - Vanderbilt University Medical Center
Anh P. Nguyen - University of California, Davis
Flory L. Nkoy - University of Utah
Thomas G. O’Connor - University of Rochester Medical Center
Emily Oken - Harvard Medical School
Dennis R. Ownby - Augusta University
Matthew Perzanowski - Columbia University
Katherine Rivera-Spoljaric - St. Louis Children's Hospital
Sheela Sathyanarayana - University of Washington
Anne Marie Singh - University of Wisconsin School of Medicine and Public Heath, Madison, Wis
Joseph B. Stanford - University of Utah
Annemarie Stroustrup - Northwell Health
Nissa Towe-Goodman - George Washington University
Veronica A. Wang - Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass
Tracey J. Woodruff - University of California, San Francisco
Robert O. Wright - Icahn School of Medicine at Mount Sinai
Rosalind J. Wright - Icahn School of Medicine at Mount Sinai
Antonella Zanobetti - Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass
Edward M. Zoratti - Henry Ford Health, Detroit, Mich
Christine C. Johnson - Henry Ford Health, Detroit, Mich
Viren D'Sa
Hans-Georg Mueller
Cristiane S. Duarte
Catherine Monk
Glorisa Canino
Jonathan Posner
Tenneill Murray
Claudia Lugo-Candelas
Anne L. Dunlop
Patricia A. Brennan
Christine Hockett
Amy Elliott
Monique M. Hedderson
John Ainsworth
Leonard B. Bacharier
Casper G. Bendixsen
Christine L.M. Joseph
Meyer Kattan
Robert F. Lemanske
Susan V. Lynch
George T. O’Connor
Carole Ober
Patrick H. Ryan
Christine M. Seroogy
Robert A. Wood
Shohreh Farzan
Deborah H. Bennett
Julie B. Schweitzer
Rebecca J. Schmidt
Janine M. LaSalle
Kate E. Keenan
Catherine J. Karr
Nicole R. Bush
Kaja Z. LeWinn
Qi Zhao
Frances Tylavsky
Christine T. Loftus
Leslie D. Leve
Jenae M. Neiderhiser
Scott T. Weiss
Augusto A. Litonjua
Eliot R. Spindel
Robert S. Tepper
Craig J. Newschaffer
Kristen Lyall
Heather E. Volk
Rebecca Landa
Sally Ozonoff
Joseph Piven
Heather Hazlett
Juhi Pandey
Robert Schultz
Steven Dager
Kelly Botteron
Daniel Messinger
Wendy Stone
Jennifer Ames
Richard K. Miller
Michele R. Hacker
Tamarra James-Todd
T. Michael O'Shea
Jean A. Frazier
Rachana Singh
Caitlin Rollins
Angela Montgomery
Ruben Vaidya
Robert M. Joseph
Lisa K. Washburn
Kelly Bear
Julie V. Rollins
Stephen R. Hooper
Genevieve Taylor
Wesley Jackson
Amanda Thompson
Julie Daniels
Michelle Hernandez
Kun Lu
Michael Msall
Madeleine Lenski
Rawad Obeid
Steven L. Pastyrnak
Elizabeth Jensen
Christina Sakai
Hudson Santos
Jean M. Kerver
Nigel Paneth
Charles J. Barone
Michael R. Elliott
Douglas M. Ruden
Chris Fussman
Julie B. Herbstman
Amy Margolis
Susan L. Schantz
Andrea Aguiar
Karen Tabb
Rita Strakovsky
Rachel Morello-Frosch
Amy Padula
Christina A. Porucznik
Angelo P. Giardino
Brent Collett
Nicole Baumann-Blackmore
Ronald Gangnon
Chris G. McKennan
Jo Wilson
Matt Altman
Stephanie L. Merhar
Gloria S. Pryhuber
Mark Hudak
Ann Marie Reynolds Lyndaker
Andrea L. Lampland
Burton Rochelson
Sophia Jan
Matthew J. Blitz
Michelle W. Katzow
Zenobia Brown
Codruta Chiuzan
Timothy Rafael
Dawnette Lewis
Natalie Meirowitz
Brenda Poindexter
Tebeb Gebretsadik
Sarah Osmundson
Jennifer K. Straughen
Amy Eapen
Andrea Cassidy-Bushrow
Ganesa Wegienka
Alex Sitarik
Audrey Urquhart
Albert Levin
Tisa Johnson-Hooper
Brent Davidson
Tengfei Ma
Emily S. Barrett
Martin J. Blaser
Maria Gloria Dominguez-Bello
Daniel B. Horton
Manuel Jimenez
Todd Rosen
Kristy Palomares
Lyndsay A. Avalos
Yeyi Zhu
Kelly J. Hunt
Roger B. Newman
Michael S. Bloom
Mallory H. Alkis
James R. Roberts
Sunni L. Mumford
Heather H. Burris
Sara B. DeMauro
Lynn M. Yee
Aaron Hamvas
Antonia F. Olidipo
Andrew S. Haddad
Lisa R. Eiland
Nicole T. Spillane
Kirin N. Suri
Stephanie A. Fisher
Jeffrey A. Goldstein
Leena B. Mithal
Raye-Ann O. DeRegnier
Nathalie L. Maitre
Ruby H.N. Nguyen
Meghan M. JaKa
Abbey C. Sidebottom
Michael J. Paidas
JoNell E. Potter
Natale Ruby
Lunthita Duthely
Arumugam Jayakumar
Karen Young
Isabel Maldonado
Meghan Miller
Jonathan L. Slaughter
Sarah A. Keim
Courtney D. Lynch
Kartik K. Venkatesh
Kristina W. Whitworth
Elaine Symanski
Thomas F. Northrup
Hector Mendez-Figueroa
Ricardo A. Mosquera
Juliette C. Madan
Debra M. MacKenzie
Johnnye L. Lewis
Brandon J. Rennie
Bennett L. Leventhal
Young Shin Kim
Somer Bishop
Sara S. Nozadi
Li Luo
Barry M. Lester
Todd Everson
Cynthia M. Loncar
Elisabeth C. McGowan
Stephen J. Sheinkopf
Brian S. Carter
Jennifer Check
Jennifer B. Helderman
Charles R. Neal
Lynne M. Smith
ECHO Cohort Consortium
Publication Details: Journal of allergy and clinical immunology, Vol.156(3), pp.627-639
Publisher: Elsevier Inc; NEW YORK
Number of pages: 13
Grant note: NCATS NIH HHS: UL1 TR002373 NHLBI NIH HHS: R01 HL159701 NIAID NIH HHS: U19 AI104317, U19 AI095227 NICHD NIH HHS: HHSN275200800031C, HHSN275200800003C, HHSN275201000009C, HHSN275200800028C, HHSN275200800002C, HHSN275200800012C, HHSN275200800003I, HHSN275200800013C, HHSN275200800002I, HHSN275200800014C NIEHS NIH HHS: U2C ES030857, U2C ES026561, P01 ES022841, U2C ES030859, R01 ES015359, U2C ES026542, U2C ES026533, U2C ES030851, P30 ES000002, U24 ES026539, P30 ES030284, U2C ES026555 NIH HHS: UH3 OD023347, UH3 OD023313, UH3 OD023348, UH3 OD023332, UG3 OD035532, UH3 OD023282, UH3 OD023286, UG3 OD035509, UH3 OD023271, UH3 OD023268, UG3 OD035521, U24 OD023382, U24 OD023319, U24 OD035523, UH3 OD023287, UG3 OD035519, UH3 OD023248, UG3 OD035516, UH3 OD023279, UG3 OD035546, UG3 OD035543, UH3 OD023251, UG3 OD035537, UG3 OD035540, UH3 OD023344, UG3 OD035508, UH3 OD023318, UH3 OD023275, UH3 OD023285, UG3 OD035544, UG3 OD035517, UH3 OD023289, UH3 OD023249, UG3 OD035550, U2C OD023375, UG3 OD035529, UG3 OD035518, UH3 OD023272, UH3 OD023389, UH3 OD023253, UH3 OD023305, UG3 OD035528, UG3 OD035533, UH3 OD023342, UH3 OD023244, UH3 OD023320, UG3 OD023316, UH3 OD023349, UG3 OD035536, UG3 OD035527, UG3 OD035513, UH3 OD023288, UH3 OD023337, UG3 OD035526, UH3 OD023365, UG3 OD035542, UG3 OD023290, UH3 OD023328
Academic Unit: Level 02 - Executives; Executives; Leadership Department; Miller School of Medicine; UMMG Dept of Obstetrics & Gynecology; School of Nursing & Health Studies; School of Nursing - Research
Language: English
Resource Type: Journal article
PMID: 40089117
Record Identifier: 991032796950902976