As pediatricians in Fresno, we read with interest The Bee article “Poverty, race drive asthma rates more than city living,” on Feb. 26.
We agree that poverty has been drastically overlooked as a contributor to asthma. About 10% of American children have asthma, which is the cause of 1.8 million ER visits per year. Caring for patients from rural, suburban and urban homes, we are acutely aware of how poverty is a determinant of asthma status, but more broadly, of child health.
In a typical day in clinic, one-third of our patients may be asthmatic — suffering from poorly controlled disease due to poor living conditions, difficulty in filling prescriptions, proximity to neighbors who smoke and a variety of other factors. Affordable housing often is located in the areas of poorer air quality as well.
Furthermore, in Fresno, we are plagued by the “obesity paradox,” where food insecurity leads to poorly nutritious food intake, leading to obesity —noteworthy as obesity is associated with poorer asthma control. We urge community leaders and health providers to prioritize addressing childhood poverty for the sake of child health.
Soniya Mehra and Rory Kretzmer