title: Path to health asthma study: A survey of pediatric asthma in an urban community.
abstract: Minority children with asthma who live in low-income urban communities bear a disproportionate burden of the disease. This study explores the perceived health care needs related to asthma care, identifies asthma triggers, potential barriers to care, and assesses the need for additional community resources.
  
  
  
  We conducted a cross-sectional survey of Hispanic and African American adults (n = 53) who take care of a child with asthma and live in an urban community of North Philadelphia. Input from community leaders was obtained in the development the survey tool resulting in a unique 'community-centric' questionnaire. The survey was also available in Spanish. All surveys were conducted in the community setting.
  
  
  
  Variables were used to measure asthma severity and triggers. Children were categorized with intermittent (n = 24, 45.3%), mild persistent (n = 13, 24.5%), or moderate-to-severe persistent asthma (n = 16, 30.2%). Most children with persistent asthma were enrolled under Medicaid or CHIP (n = 24, p = 0.011) and reflected a low-income socioeconomic status. Persistent asthma was found to be associated with most triggers: pets, dust mites, mice, mold, and cockroaches. There was no significant association between environmental tobacco smoke and persistent asthma. Children with persistent asthma and 2 or more triggers were more likely to be hospitalized and go to the Emergency Department.
  
  
  
  Urban minority children living in low-income communities face neighborhood-specific asthma triggers and challenges to care. Studies conducted in urban neighborhoods, with collaboration from community members, will highlight the need of comprehensive services to account for community-centric social determinants.
authors.affiliation: a Lewis Katz School of Medicine at Temple University , Philadelphia , PA , USA.
authors.forename: Norma
authors.initials: N
authors.lastname: Alicea-Alvarez
authors.affiliation: b Internal Medicine/Pediatrics, University of Maryland Medical Center , Baltimore , MD , USA.
authors.forename: Carlo
authors.initials: C
authors.lastname: Foppiano Palacios
authors.affiliation: c Lewis Katz School of Medicine, Temple University , Philadelphia , PA , USA.
authors.forename: Melanie
authors.initials: M
authors.lastname: Ortiz
authors.affiliation: c Lewis Katz School of Medicine, Temple University , Philadelphia , PA , USA.
authors.forename: Diana
authors.initials: D
authors.lastname: Huang
authors.affiliation: d Office of Health Equity, Diversity and Inclusion Director, Center for Bioethics, Urban Health, and Policy, Lewis Katz School of Medicine, Temple University , Philadelphia , PA , USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Reeves
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D017668:Age of Onset; D001249:Asthma / Q000188:drug therapy / Q000208:ethnology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004777:Environment; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data; D020380:Needs Assessment; D015143:Philadelphia / Q000453:epidemiology; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D014481:United States; D014505:Urban Population / Q000706:statistics & numerical data*
keywords: Medicaid; Pediatrics; Philadelphia; asthma; low-income; social determinants; triggers