In the first seven weeks of school, the rates of asthma-related emergency room visits spike — peaking around the third week — but that spike is even more pronounced in neighborhoods with increased disadvantages measured by the social vulnerability index.
Asthma incidents increase with the common cold virus, Bhavnani said, and as kids go back to school, they are exposed to cold viruses that many of them weren’t in contact with during the summer.
The big question Bhavnani and her colleagues are asking: Why are the asthma-related ER visits worse in poorer neighborhoods?
Bhavnani looked at more than 3,000 census tracts in Austin, San Antonio, Dallas and Houston from 2016 to 2019 and the asthma-related ER visits from kids ages 5 to 17 in those census tracts.
The social vulnerability index considers things like high poverty, low percentage of vehicle access, crowded households and other factors that affect a community’s ability to handle or come back from a disaster.
Bhavnani has been working on asthma incidents and the relationship to common cold viruses as well as the relationship to poverty levels.
She wonders if areas of poverty have more exposure to the cold viruses because of factors such as crowded classrooms and crowded living conditions, families that cannot take off work when a child is sick and sends them to school anyway, and environmental factors in the home or schools.
“What are the pathways that might leave a child living in an unhealthy home in a poor neighborhood?” Bhavnani is asking herself. She’s looking at indoor and outdoor air quality, building materials, crowding and access to health care.
“What our research shows that is really telling is these asthma attacks are so closely linked to the common cold virus,” she said, and “there’s a greater burden when children went back to school. A spike happened and quickly spread, but they spread more quickly in poorer neighorhoods,” Bhavnani said.
Currently she’s looking at the neighborhood level and in homes in those neighborhoods. Eventually, she’ll look at factors in schools.
A lot more research and understanding is needed to fully understand the spike and the increase based on neighborhood poverty level. She wonders about environmental factors as well as birth and life experiences that might have lowered the immune system’s response to the virus.
And while we don’t have a vaccine for the common cold, Bhavnani said, vaccinations help prevent many childhood diseases that could lead to respiratory difficulties and more asthma events.
Based on her research, Bhavnani has these recommendations to limit the asthma incident rates:
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