JAMA Network Open Publishes Article on Housing Conditions and Adult Asthma Burden

By Ella Izenour, NLIHC Opportunity Starts at Home Intern 

JAMA Network Open published a recent article, “Tenant Reports of In-Home Asthma Triggers and Adult Emergency Department Use,” examining the association between tenant-reported residential asthma triggers and adult asthma emergency department visits. The cross-sectional study, conducted in Boston, utilized data from the city’s housing code enforcement system and health system electronic records. The authors found that tenant-reported asthma triggers were significantly associated with higher rates of adult asthma emergency department visits, underscoring the need for universal access to healthy housing to reduce health disparities.  

The authors analyzed data from the Massachusetts General Brigham health system electronic health records (EHR) and tenant requests for home inspections by code enforcement officers. The study included 2,406 emergency department visits from 1,698 unique patients and 7,259 tenant reports across 552 residential block groups. Eight categories of tenant reports were identified as relevant to asthma: excessive or insufficient heat, pest infestation, mice infestation, bed bugs, chronic dampness or mold, poor ventilation, rodent activity. Data were also collected from Breathe Easy, a program in Boston that allows clinicians to report asthma triggers directly to the Inspectional Services Department.  

The findings demonstrate a link between unhealthy housing and asthma at the population level in Boston. Increases in tenant reports of in-home asthma triggers were associated with a rise in neighborhood rates of adult asthma related emergency department visits. Neighborhoods with higher proportions of Black or Latino residents had at least 72% higher rates of asthma triggers. 

The article concludes by emphasizing the role of unhealthy housing in asthma burden differences between neighborhoods across Boston. It calls for greater investment in housing code enforcement and universal access to healthy housing to reduce asthma rates and disparities. The authors also highlight the broader, multi-sector impacts of improved housing conditions, noting healthy housing as a pathway to reducing psychosocial stress experienced by racial minorities, which contributes to worse asthma outcomes.   

Read the article here.  

To learn more about the intersections between housing and health, read the OSAH fact sheet here.