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Childhood Asthma Rates Are Highest In North St. Louis, Wash U Study Finds

Cenya Davis puffs on her inhaler earlier this month. The 8-year-old student at Gateway Elementary School in St. Louis has been to the hospital three times for breathing trouble starting in December. She now regularly uses the inhaler.
Ryan Delaney | St. Louis Public Radio

A Washington University study has shown that more than a dozen north St. Louis neighborhoods have high rates of childhood asthma. 

The study, soon to be published in the journal Social Science & Medicine, identified five ZIP codes in St. Louis that are hot spots for childhood asthma, meaning that they contain clusters for the city's highest rates of the illness. The report used census and health data from multiple government agencies.

The rate of hospitalizations for childhood asthma for those ZIP codes, which include downtown St. Louis, Baden and North Riverfront neighborhoods, are five times that of two ZIP codes in southwest St. Louis, which have the lowest presence of the illness.

The hot spots highlighted in the paper are home to mostly black and low-income residents. Health care resources are more scarce in those areas than in other parts of the city, said Kelly Harris, a postdoctoral researcher at Washington University’s Child Health and Education Laboratory.

“Areas of higher asthma rates are not near where providers are,” Harris said. “And there are fewer pharmacies in areas with higher prevalence. Thinking about children who might be using emergency rooms for their medical care, it’s a call for more research in that area.”

The study notes a vast geographic disparity in pediatricians and doctors that specialize in allergy or immunology. Less than a percent of them work in the five ZIP codes with the highest childhood asthma rates, and 81 percent work in children's hospitals that are located in areas where there are low rates of the illness. While the study did not analyze transportation systems, it’s something worth looking into next, Harris said.


City health officials have been aware of the lack of access to health care services in some neighborhoods. The St. Louis Department of Health has tried to remedy that by having health care practitioners visit the homes of people who suffer from asthma, said Lakiska Stephenson, a public health program representative for the city’s department.

“Most of the people in north St. Louis use the emergency room for their primary care physicians,” Stephenson said. “If they were educated about asthma and the triggers and what can help them reduce that, that would help a great abundance. But there’s not that many primary care physicians in those areas.”

The report also describes numerous factors that could potentially help explain why childhood asthma rates are so high in those areas. There’s more violent crime, public housing and deteriorating buildings in those areas, Harris said.

“When we think about policy solutions, we tend to think in a siloed manner,” Harris said. The paper shows that all of these factors influence [childhood asthma], so perhaps we should think about interdisciplinary solutions.”

Harris’ next steps involve looking into how childhood asthma could be affecting academic performance among children in St. Louis.

“Asthma illnesses keep kids out of the classroom, which impacts their academic performance, their ability to connect to the school environment, in some cases, their motivation,” she said.

St. Louis, overall, has among the highest rates of asthma in the country. Asthma rates are also higher for black St. Louis residents than white residents, and they’re rising for black children and adults, according to 2015 data from the city department of health.

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Eli is the science and environment reporter at St. Louis Public Radio.