Abstract：
BACKGROUND: The discriminatory and racist policy of historical redlining in the United States during the 1930s played a role in perpetuating contemporary environmental health disparities.
OBJECTIVE: Our objectives were to determine associations between home and school pollutant exposure (fine particulate matter [PM2.5], NO2) and respiratory outcomes (Composite Asthma Severity Index, lung function) among school-aged children with asthma and examine whether associations differed between children who resided and/or attended school in historically redlined compared to non-redlined neighborhoods.
METHODS: Children ages 6 to 17 with moderate-to-severe asthma (N = 240) from 9 US cities were included. Combined home and school exposure to PM2.5 and NO2 was calculated based on geospatially assessed monthly averaged outdoor pollutant concentrations. Repeated measures of Composite Asthma Severity Index and lung function were collected.
RESULTS: Overall, 37.5% of children resided and/or attended schools in historically redlined neighborhoods. Children in historically redlined neighborhoods had greater exposure to NO2 (median: 15.4 vs 12.1 parts per billion) and closer distance to a highway (median: 0.86 vs 1.23 km), compared to those in non-redlined neighborhoods (P < .01). Overall, PM2.5 was not associated with asthma severity or lung function. However, among children in redlined neighborhoods, higher PM2.5 was associated with worse asthma severity (P < .005). No association was observed between pollutants and lung function or asthma severity among children in non-redlined neighborhoods (P > .005).
CONCLUSIONS: Our findings highlight the significance of historical redlining and current environmental health disparities among school-aged children with asthma, specifically, the environmental injustice of PM2.5 exposure and its associations with respiratory health.
OBJECTIVE: Our objectives were to determine associations between home and school pollutant exposure (fine particulate matter [PM2.5], NO2) and respiratory outcomes (Composite Asthma Severity Index, lung function) among school-aged children with asthma and examine whether associations differed between children who resided and/or attended school in historically redlined compared to non-redlined neighborhoods.
METHODS: Children ages 6 to 17 with moderate-to-severe asthma (N = 240) from 9 US cities were included. Combined home and school exposure to PM2.5 and NO2 was calculated based on geospatially assessed monthly averaged outdoor pollutant concentrations. Repeated measures of Composite Asthma Severity Index and lung function were collected.
RESULTS: Overall, 37.5% of children resided and/or attended schools in historically redlined neighborhoods. Children in historically redlined neighborhoods had greater exposure to NO2 (median: 15.4 vs 12.1 parts per billion) and closer distance to a highway (median: 0.86 vs 1.23 km), compared to those in non-redlined neighborhoods (P < .01). Overall, PM2.5 was not associated with asthma severity or lung function. However, among children in redlined neighborhoods, higher PM2.5 was associated with worse asthma severity (P < .005). No association was observed between pollutants and lung function or asthma severity among children in non-redlined neighborhoods (P > .005).
CONCLUSIONS: Our findings highlight the significance of historical redlining and current environmental health disparities among school-aged children with asthma, specifically, the environmental injustice of PM2.5 exposure and its associations with respiratory health.
摘要：
背景：1930年代美国（美国）历史上的歧视性和种族主义政策在延续当代环境健康差异方面发挥了作用。
目标：我们的目标是确定家庭和学校污染物暴露（细颗粒物（PM2.5），二氧化氮(NO2)和呼吸结果(综合哮喘严重程度指数(CASI)，肺功能）在患有哮喘的学龄儿童中，并检查与未加红的社区相比，在历史加红的社区中居住和/或上学的儿童之间的关联是否存在差异。
方法：纳入美国9个城市的6至17岁中度至重度哮喘（N=240）儿童。根据地理空间评估的每月平均室外污染物浓度，计算了家庭和学校对PM2.5和NO2的综合暴露。收集CASI和肺功能的重复测量。
结果：总体而言，37.5％的儿童在历史上有红线的社区居住和/或上学。历史上有红线的社区中的儿童对NO2的暴露更大（中位数：15.4对12.1ppb），并且与高速公路的距离更近（中位数：0.86对1.23km），与非红线社区相比（p<0.01）。总的来说,PM2.5与哮喘严重程度或肺功能无关。然而,在红线社区的孩子中，PM2.5升高与哮喘严重程度恶化相关(p<0.005).在非红线区域的儿童中，未观察到污染物与肺功能或哮喘严重程度之间的关联（p>0.005）。
结论：我们的研究结果强调了哮喘学龄儿童的历史修订和当前环境健康差异的重要性，具体来说,PM2.5暴露的环境不公及其与呼吸健康的关系。
目标：我们的目标是确定家庭和学校污染物暴露（细颗粒物（PM2.5），二氧化氮(NO2)和呼吸结果(综合哮喘严重程度指数(CASI)，肺功能）在患有哮喘的学龄儿童中，并检查与未加红的社区相比，在历史加红的社区中居住和/或上学的儿童之间的关联是否存在差异。
方法：纳入美国9个城市的6至17岁中度至重度哮喘（N=240）儿童。根据地理空间评估的每月平均室外污染物浓度，计算了家庭和学校对PM2.5和NO2的综合暴露。收集CASI和肺功能的重复测量。
结果：总体而言，37.5％的儿童在历史上有红线的社区居住和/或上学。历史上有红线的社区中的儿童对NO2的暴露更大（中位数：15.4对12.1ppb），并且与高速公路的距离更近（中位数：0.86对1.23km），与非红线社区相比（p<0.01）。总的来说,PM2.5与哮喘严重程度或肺功能无关。然而,在红线社区的孩子中，PM2.5升高与哮喘严重程度恶化相关(p<0.005).在非红线区域的儿童中，未观察到污染物与肺功能或哮喘严重程度之间的关联（p>0.005）。
结论：我们的研究结果强调了哮喘学龄儿童的历史修订和当前环境健康差异的重要性，具体来说,PM2.5暴露的环境不公及其与呼吸健康的关系。
