Historic racism in Kansas City affects Today's pediatric asthma burden

ElsevierVolume 78, November 2022, 102927Health & PlaceHighlights•

Historic structural racism impacts present day child respiratory health.

Identifying historical contributions to inequity yields opportunity for discussion.

Assessing neighborhood level health yields opportunity for focused interventions.

Abstract

Asthma morbidity is unequally distributed across populations throughout the United States, and reasons remain unclear. To assess how historical structural racism correlates with current day asthma disparities, we conducted a retrospective cohort study of 10,736 pediatric patients, ages 3–19 years, with two or more asthma encounters between October 2017–October 2019. Patient addresses were matched with historic Home Owners' Loan Corporation (HOLC) maps – which provide a measure of historic structural racism. Residential proximity to pollution sources served as an additional exposure measure. Healthcare utilization and asthma severity were studied against age, race, SES, geographic proximity to pollution, and HOLC grades. Patients living in historically divested neighborhoods and BIPOC patients were likely to require more acute care for asthma, even when adjusting for present day SES and residential proximity to pollution sources. This supports the assertion that historic structural racism influences present-day health.

Keywords

Asthma

Redlining

HOLC

Structural racism

Kansas city

Neighborhood

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© 2022 Published by Elsevier Ltd.

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