Torie Grant MD MHS Emily Croce MSN APRN CPNPPC Elizabeth C Matsui MD MHS Ann Allergy Asthma Immunol January 20221281511 Asthma and the Social Determinants of Health Key Messages ID: 911536
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Slide1
Slide2Asthma and the Social Determinants of Health
Torie Grant, MD, MHS
Emily Croce, MSN, APRN, CPNP-PC
Elizabeth C. Matsui
, MD, MHS
Ann Allergy Asthma Immunol. January 2022;128(1):5-11
Slide3Asthma and the Social Determinants of Health
Key Messages
There is increasing recognition that social determinants of health (
SDoH
), including socioeconomic status, physical environment, and health care, influence racial and ethnic asthma disparities, yet little research has focused on which SDoH and to what degree SDoH are driving these disparities.Low income is linked to asthma prevalence, exacerbations, hospitalizations, and intensive care unit admission. In addition to low income, inequities in wealth, homeownership, educational attainment, and employment opportunities contribute to asthma disparities.
Poor housing conditions, including home disrepair and exposure to pests, mold, and pollution, have been associated with increased risk of childhood asthma and asthma morbidity. Observational data suggest that reductions in these environmental exposures could improve childhood lung function trajectory and reduce the risk of lung disease in adulthood.
Long-term stress is a risk factor of asthma morbidity and likely has direct effects through T helper 2 immune responses and hypothalamic-pituitary-adrenocortical activation. Long-term stress may mediate the effects of
SDoH
on asthma risk.
Grant, et al. Ann Allergy Asthma Immunol. January 2022;128(1):5-11
Slide4The Relationship of Racism,
SDoH
, and Asthma Risk
and Disparity in the United States
Grant, et al. Ann Allergy Asthma Immunol. January 2022;128(1):5-11
Slide5Social Determinants of Health
and Primary Immunodeficiency
Yael Dlnur-Schejter, MD
Polina Stepensky, MD
Ann Allergy Asthma Immunol. January 2022;128(1):12-18
Slide6Social Determinants of Health and Primary Immunodeficiency
Key Messages
Infectious presentation of inborn errors of immunity (IEI) can be different in various regions of the world, depending on the local distribution of infectious organism and the local vaccine protocols.
The distribution and severity of IEI are affected by rates of consanguinity in the population.
Prevention of IEI can be achieved by premarital, pregestational, or prenatal genetic counseling and diagnosis, which must be tailored to the genetic predisposition and ethical code of a patient.Access to treatment for IEI is scarce in certain regions of the world, most notably the access to timely hematopoietic stem cell transplantation and newer treatment modalities.Collaboration between low- and medium-income countries with increased rates of IEI and Western countries with improved research and diagnosis modalities has improved our diagnosis and understanding of IEI.
Dlnur-Schejter and Stepensky. Ann Allergy Asthma Immunol. January 2022;128(1):12-18
Slide7Distribution of IEI in Association to Rate of Consanguinity
Dlnur-Schejter and Stepensky. Ann Allergy Asthma Immunol. January 2022;128(1):12-18
Slide8International Collaborations in the Diagnosis of New IEIs
Dlnur-Schejter and Stepensky. Ann Allergy Asthma Immunol. January 2022;128(1):12-18
Slide9The COVID-19 Pandemic:
Adverse Effects on the Social Determinants of Health
in Children and Families
Elissa M. Abrams, MD, MPH
Matthew Greenhawt, MD, MBA, MSc Marcus Shaker, MD, MScAndrew D. Pinto, MD, MScIan Sinha, MBBS, FRCPCH, PhDAlexander Singer, MB, BAO, BCh
Ann Allergy Asthma Immunol. January 2022;128(1):19-25
Slide10The COVID-19 Pandemic
Key Messages
Social determinants of health have helped contribute to the detrimental impact of coronavirus disease 2019 (COVID-19) on pediatric health, apart from direct disease manifestations.
COVID-19 has affected Black communities disproportionately, including higher infection and fatality rates and lower vaccination rates.
Households experiencing homelessness and housing insecurity as a result of the pandemic were associated with increased COVID-19–related morbidity and morbidity, secondary to reduced access to public health measures to reduce disease transmission.Food insecurity among children has risen dramatically as a result of the pandemic, influenced in part by reduced access to school lunches, fragility in the food supply chain, rising food costs, and risks of unemployment.Rates of extreme poverty (living on <$1.90 per day) are anticipated to rise for the first time in 20 years. Poverty is a negative influence on child health, in particular long-term conditions and mental health.Domestic violence, including child abuse and intimate partner violence, has increased during the pandemic, both of which are associated with long-term adverse health outcomes in children.
Abrams, et al. Ann Allergy Asthma Immunol. January 2022;128(1):19-25
Slide11Adverse Social Determinants of Health and the Impact on Children and Families During the COVID-19 Pandemic
Abrams, et al. Ann Allergy Asthma Immunol. January 2022;128(1):19-25
Slide12Future Steps to Addressing COVID-19 Pandemic-Related Social Disparities Affecting Children and their Families
Abrams, et al. Ann Allergy Asthma Immunol. January 2022;128(1):19-25