Social determinants: taking the social context of asthma seriously.
Although asthma has emerged as a major contributor to disease and disability among US children, the burden of this disease is unevenly distributed within the population. This article provides a brief overview of social-status variables that predict variations in asthma risks and social exposures, such as stress and violence, that are emerging as important risk factors. The central focus of the article is on the distal social variables that have given rise to unhealthy residential environments in which the risk factors for asthma and other diseases are clustered. Effective initiatives for the prevention and treatment of childhood asthma need to address these nonmedical determinants of the prevalence of asthma.
Williams
David R
DR
Harvard School of Public Health, Department of Society, Human Development, and Health, Harvard University, 677 Huntington Ave, Boston, MA 02115, USA. dwilliam@hsph.harvard.edu
Sternthal
Michelle
M
Wright
Rosalind J
RJ
D001249:Asthma / Q000453:epidemiology*; D017028:Caregivers / Q000523:psychology; D002648:Child; D003695:Delivery of Health Care; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D054624:Health Status Disparities; D006801:Humans; D011203:Poverty; D044469:Racial Groups; D012111:Residence Characteristics; D012307:Risk Factors; D012931:Social Environment; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014505:Urban Population; D014754:Violence