Physical and Social Environmental Influences on Asthma and Asthma Disparities

Although traditional disciplinary research theory and methods have focused separately on how social and physical environmental factors affect childhood asthma, evolving research underscores important integrated effects. It is now widely accepted that advancing our understanding of asthma risk requires attention to both physical environmental hazards and social conditions. Marginalized populations of lower socioeconomic position are disproportionately exposed to irritants (e.g., tobacco smoke), pollutants (e.g., diesel-related particles), and indoor allergens (e.g., cockroach and mouse allergen) that are known contributors to asthma morbidity. Moreover, these individuals may also live in communities that are increasingly socially toxic that, in turn, may contribute to increased psychosocial stress that also influences asthma expression. Owing to the covariance across exposures and evidence that social stress and other environmental toxins (e.g., pollutants and tobacco smoke) may influence common physiological pathways (e.g., oxidative stress, proinflammatory immune pathways, and autonomic disruption), understanding the potential synergistic effects among physical and social determinants promises to more completely inform asthma epidemiology.