ArticleThe Journal of allergy and clinical immunology2025
Child Opportunity Index at birth and asthma with recurrent exacerbations in the US ECHO program.
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Article in The Journal of allergy and clinical immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Update on environmental determinants of allergic diseases.The Journal of allergy and clinical immunology · 2026Review
- Current Practices and Variations Among Pediatric Severe Asthma Programs in the United States-The North American Severe Pediatric Asthma Consortium.Pediatric pulmonology · 2026Observational
- Associations of Community Material Neighborhood Deprivation With the Diagnosis of Asthma Among Infants With Bronchopulmonary Dysplasia (BPD).Pediatric pulmonology · 2026Article
- Prenatal exposure to environmental phenolic compounds and their association with childhood atopic dermatitis, asthma, and allergic rhinitis in the ECHO cohort.Environment international · 2025Article
- Association between income, employment status, and asthma outcomes: a systematic review and meta-analysis.The Lancet regional health. Europe · 2025Article
- From lockdown to recovery: changing patterns of viral infection severity in a pediatric cohort with asthma.Frontiers in allergy · 2025Article
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Authors and funding
59 authors.
Rachel L MillerDepartment of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: Rachel.miller2@mssm.edu.
Holly SchuhJohns Hopkins University Bloomberg School of Public Health, Baltimore, Md.
Aruna ChandranJohns Hopkins University Bloomberg School of Public Health, Baltimore, Md.
Rima HabreKeck School of Medicine of University of Southern California, Los Angeles, Calif.
Jyoti AngalUniversity of South Dakota Sanford School of Medicine, Sioux Falls, SD; Avera Research Institute, Sioux Falls, SD.
Izzuddin M ArisDepartment of Population Medicine, Harvard Medical School, Boston, Mass; Department of Harvard Pilgrim Health Care Institute, Boston, Mass.
Judy L AschnerCenter for Discovery and Innovation, Hackensack Meridian School of Medicine, Nutley, NJ; Albert Einstein College of Medicine, Bronx, NY.
Casper G BendixsenNational Farm Medicine Center, Marshfield Clinic Research Institute, Marshfield, Wis.
Jeffrey BlossomHarvard University Center for Geographic Analysis, Cambridge, Mass.
Michelle Bosquet-EnlowDepartment of Psychiatry, Harvard Medical School, Boston, Mass; Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, Mass.
Carrie V BretonKeck School of Medicine of University of Southern California, Los Angeles, Calif.
Carlos A CamargoDepartment of Massachusetts General Hospital, Harvard Medical School, Boston, Mass.
Kecia N CarrollDepartment of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
Sarah CommodoreMedical University of South Carolina, Charleston, SC.
Lisa A CroenDivision of Research, Kaiser Permanente Northern California, Oakland, Calif.
Dana M DabeleaUniversity of Colorado Anschutz Medical Campus, Aurora, Colo.
Sean C L DeoniBill and Melinda Gates Foundation, Seattle, Wash.
Assiamira FerraraDivision of Research, Kaiser Permanente Northern California, Oakland, Calif.
Rebecca C FryDepartment of Gillings School of Global Public Health and the Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Jody M GanibanDepartment of Psychological and Brain Sciences, George Washington University, Washington, DC.
Sarah D GeigerDepartment of Kinesiology and Community Health, University of Illinois, Champaign, Ill; Beckman Institute for Advanced Science and Technology, Urbana, Ill.
James E GernUniversity of Wisconsin School of Medicine and Public Heath, Madison, Wis.
Frank D GillilandKeck School of Medicine of University of Southern California, Los Angeles, Calif.
Semsa GogcuWake Forest University School of Medicine, Salem, NC.
Diane R GoldDepartment of Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass.
Marion E HareUniversity of Tennessee Health Science Center, Memphis, Tenn.
Robyn N HarteColorado School of Public Health, Aurora, Colo.
Tina V HartertDepartment of Medicine, Vanderbilt University Medical Center, Nashville, Tenn; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn.
Irva Hertz-PicciottoDepartment of University of California Davis Health, Davis, Calif.
Alison E HipwellDepartment of Psychiatry, University of Pittsburgh, Pittsburgh, Pa.
Daniel J JacksonUniversity of Wisconsin School of Medicine and Public Heath, Madison, Wis.
Margaret K KaragasGeisel School of Medicine at Dartmouth, Hanover, NH.
Gurjit K Khurana HersheyUniversity of Cincinnati, Cincinnati, Ohio; Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Haejin KimHenry Ford Health, Detroit, Mich.
Augusto A LitonjuaGolisano Children's Hospital, University of Rochester Medical Center, Rochester, NY.
Carmen J MarsitRollins School of Public Health, Emory University, Atlanta, Ga.
Cynthia T McEvoyDepartment of Pediatrics, Pape Pediatric Research Institute, Oregon Health and Science University, Portland, Ore.
Eneida A MendonçaUniversity of Cincinnati, Cincinnati, Ohio; Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Paul E MooreDepartment of Medicine, Vanderbilt University Medical Center, Nashville, Tenn; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn.
Anh P NguyenDepartment of University of California Davis Health, Davis, Calif.
Flory L NkoyUniversity of Utah Health, Salt Lake City, Utah.
Thomas G O'ConnorGolisano Children's Hospital, University of Rochester Medical Center, Rochester, NY.
Emily OkenDepartment of Population Medicine, Harvard Medical School, Boston, Mass; Department of Harvard Pilgrim Health Care Institute, Boston, Mass.
Dennis R OwnbyDivision of Allergy and Immunology, Augusta University, Augusta, Ga.
Matthew PerzanowskiColumbia University Mailman School of Public Health, New York, NY.
Katherine Rivera-SpoljaricSt Louis Children's Hospital, Washington University, St Louis, Mo.
Sheela SathyanarayanaDepartment of Pediatrics, University of Washington, Seattle, Wash; Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Wash; Department of Epidemiology, University of Washington, Seattle, Wash.
Anne Marie SinghUniversity of Wisconsin School of Medicine and Public Heath, Madison, Wis.
Joseph B StanfordUniversity of Utah Health, Salt Lake City, Utah.
Annemarie StroustrupNorthwell Health, New York, NY.
Nissa Towe-GoodmanDepartment of Psychological and Brain Sciences, George Washington University, Washington, DC.
Veronica A WangDepartment of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass.
Tracey J WoodruffProgram on Reproductive Health and the Environment, University of California, San Francisco, Calif; Environmental Research and Translation for Health Center, University of California, San Francisco, Calif.
Robert O WrightDepartment of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
Rosalind J WrightDepartment of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
Antonella ZanobettiDepartment of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass.
Edward M ZorattiHenry Ford Health, Detroit, Mich.
Christine C JohnsonHenry Ford Health, Detroit, Mich.
ECHO Cohort Consortium
Funding
Project-005U2COD023375 · OD · DUKE UNIVERSITY · PI Linda S Adair, Phillip Brian Smith · 2016 to 2026
$215.9MECHODAC (Environmental Influences on Child Health Outcomes Data Analysis Center)U24OD023382 · OD · JOHNS HOPKINS UNIVERSITY · PI Diane J Catellier, LISA P JACOBSON · 2016 to 2026
$148.4MUniversity of Wisconsin Institute for Clinical and Translational ResearchUL1TR002373 · NCATS · UNIVERSITY OF WISCONSIN-MADISON · PI ELIZABETH S BURNSIDE, Allan R. Brasier · 2017 to 2026
$75.9MWisconsin Infant Study Cohort (WISC) ECHO Pediatric Follow-UpUH3OD023282 · OD · UNIVERSITY OF WISCONSIN-MADISON · PI James E. Gern · 2018 to 2026
$64.8MThe NYU Children’s Health & Environment Study: an ECHO CohortUH3OD023305 · OD · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI Akhgar Ghassabian, Leonardo Trasande · 2018 to 2026
$59.5MMount Sinai ECHO site for Perinatal Environment and Development StudiesUH3OD023337 · OD · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI KECIA Nicole CARROLL, Robert O Wright · 2018 to 2026
$54.1MConduits: Mount Sinai Health System Translational Science HubUL1TR004419 · NCATS · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI Rosalind J Wright · 2022 to 2026
$46.4MTranslational Research Support CoreP30ES000002 · NIEHS · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI JAIME ELIZABETH HART · 1985 to 2026
$44.6MA prospective study of critical environmental exposures in formative early life that impact lifelong health in rural US children: the New Hampshire Birth Cohort StudyUH3OD023275 · OD · DARTMOUTH COLLEGE · PI MARGARET Rita KARAGAS, Juliette Madan · 2018 to 2026
$44.3MThe ECHO Measurement Core: A Framework and Resource for Assessing Environmental Exposure and Child HealthU24OD023319 · OD · NORTHWESTERN UNIVERSITY AT CHICAGO · PI Courtney K Blackwell, RICHARD GERSHON · 2016 to 2026
$43.7MXENOBIOTIC BIOTRANSFORMATION AND DISPOSITIONP30ES007033 · NIEHS · UNIVERSITY OF WASHINGTON · PI Nicole Ann Errett · 1995 to 2026
$42.5MPrenatal and Early Childhood Pathways To Health: An Integrated Model of Chemical and Social Exposures, Biological Mechanisms, and Sex-Specific Effects on Neurodevelopment and Respiratory OutcomesUH3OD023271 · OD · UNIVERSITY OF WASHINGTON · PI BUSH, NICOLE RENEE, KARR, CATHERINE J · 2018 to 2022
$37.3MNCATS NIH HHS UL1 TR002373NCATS NIH HHS UL1 TR004419NHLBI NIH HHS R01 HL159701NIAID NIH HHS U19 AI095227NIAID NIH HHS U19 AI104317NIAID NIH HHS U24 AI179612NICHD NIH HHS HHSN275200800002CNICHD NIH HHS HHSN275200800002INICHD NIH HHS HHSN275200800003CNICHD NIH HHS HHSN275200800003INICHD NIH HHS HHSN275200800012CNICHD NIH HHS HHSN275200800013CNICHD NIH HHS HHSN275200800014CNICHD NIH HHS HHSN275200800028CNICHD NIH HHS HHSN275200800031CNICHD NIH HHS HHSN275201000009CNIDDK NIH HHS P30 DK048520NIEHS NIH HHS P01 ES022841NIEHS NIH HHS P30 ES000002NIEHS NIH HHS P30 ES007033NIEHS NIH HHS P30 ES013508NIEHS NIH HHS P30 ES030284NIEHS NIH HHS R01 ES015359NIEHS NIH HHS T32 ES007069NIEHS NIH HHS U24 ES026539NIEHS NIH HHS U2C ES026533NIEHS NIH HHS U2C ES026542NIEHS NIH HHS U2C ES026555NIEHS NIH HHS U2C ES026561NIEHS NIH HHS U2C ES030851NIEHS NIH HHS U2C ES030857NIEHS NIH HHS U2C ES030859NIH HHS U24 OD023319NIH HHS U24 OD023382NIH HHS U24 OD035523NIH HHS U2C OD023375NIH HHS UG3 OD023290NIH HHS UG3 OD023316NIH HHS UG3 OD023365NIH HHS UG3 OD035508NIH HHS UG3 OD035509NIH HHS UG3 OD035513NIH HHS UG3 OD035516NIH HHS UG3 OD035517NIH HHS UG3 OD035518NIH HHS UG3 OD035519NIH HHS UG3 OD035521NIH HHS UG3 OD035526NIH HHS UG3 OD035527NIH HHS UG3 OD035528NIH HHS UG3 OD035529NIH HHS UG3 OD035532NIH HHS UG3 OD035533NIH HHS UG3 OD035536NIH HHS UG3 OD035537NIH HHS UG3 OD035540NIH HHS UG3 OD035542NIH HHS UG3 OD035543NIH HHS UG3 OD035544NIH HHS UG3 OD035546NIH HHS UG3 OD035550NIH HHS UH3 OD023244NIH HHS UH3 OD023248NIH HHS UH3 OD023249NIH HHS UH3 OD023251NIH HHS UH3 OD023253NIH HHS UH3 OD023268NIH HHS UH3 OD023271NIH HHS UH3 OD023272NIH HHS UH3 OD023275NIH HHS UH3 OD023279NIH HHS UH3 OD023282NIH HHS UH3 OD023285NIH HHS UH3 OD023286NIH HHS UH3 OD023287NIH HHS UH3 OD023288NIH HHS UH3 OD023289NIH HHS UH3 OD023305NIH HHS UH3 OD023313NIH HHS UH3 OD023318NIH HHS UH3 OD023320NIH HHS UH3 OD023328NIH HHS UH3 OD023332NIH HHS UH3 OD023337NIH HHS UH3 OD023342NIH HHS UH3 OD023344NIH HHS UH3 OD023347NIH HHS UH3 OD023348NIH HHS UH3 OD023349NIH HHS UH3 OD023365NIH HHS UH3 OD023389NIH HHS UH3 OD035509NIH HHS UH3 OD035516NIH HHS UH3 OD035518NIH HHS UH3 OD035519NIH HHS UH3 OD035521NIH HHS UH3 OD035529NIH HHS UH3 OD035533NIH HHS UH3 OD035536NIH HHS UH3 OD035542NIH HHS UH3 OD035543
Abstract
backgroundEnvironmental exposures and social determinants likely influence specific childhood asthma phenotypes.
objectiveWe hypothesized that the Child Opportunity Index (COI) at birth, measuring multiple neighborhood opportunities, influences incidence rates (IRs) for asthma with recurrent exacerbations (ARE).
methodsWe tested for COI associations with ARE IRs in 15,877 children born between 1990 and 2018 in the ECHO (Environmental Influences on Child Health Outcomes) program. Parent-reported race and ethnicity and other demographics were assessed as effect modifiers.
resultsThe IRs of ARE for children born in very low COI neighborhoods was higher (IR = 10.98; 95% CI: 9.71, 12.25) than for other COI categories. Rates for non-Hispanic Black (NHB) children were significantly higher than non-Hispanic White children in every COI category. The ARE IRs for children born in very low COI neighborhoods were several-fold higher for NHB and Hispanic Black children (IR = 15.30; 95% CI: 13.10, 17.49; and IR = 18.48; 95% CI: 8.80, 28.15, respectively) when compared to White children. Adjusting for individual-level characteristics, children born in very low COI neighborhoods demonstrated an ARE IR ratio of 1.26 (95% CI: 0.99, 1.59) with a higher incidence of cases among children ages 2 to 4 years and with a parental history of asthma.
conclusionsRates of ARE were higher among children born in under-resourced communities, and this relationship is strongest for young minoritized children with a parental history of asthma. Higher rates for NHB even in the highest COI categories suggest that risk associated with race persists regardless of social disadvantage.
Indexed as
AsthmaEnvironmental ExposureBlack or African AmericanChildChild, PreschoolFemaleHumansIncidenceInfantMaleNeighborhood CharacteristicsRecurrenceUnited StatesWhiteAsthmachild opportunity indexenvironmental and social determinants of asthmaincidence ratesrecurrent asthma exacerbations
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