Children from low-income family more likley to have severe asthma

Children with severe asthma remarkably often live in rented housing and come from low-income families, often with parents or grandparents who immigrated to the Netherlands, researchers from the Emma Children’s Hospital at Amsterdam UMC discovered. In asthma hotspots, kids from the lowest income group are over 2.5 times more likely to end up in an emergency room with severe asthma than children from high-income families in the area, RTL Nieuws reports.

The researchers analyzed 4.5 million children in the Netherlands aged 2 to 17, using anonymized data from Statistics Netherlands (CBS) to link residential and income information with hospital visits.

“Many people think that heredity is the most important factor, because children of parents with asthma or allergies are more likely to develop the disease. But factors like air pollution, such as particulate matter, exhaust fumes, and exposure to cigarette smoke, increase the risk. Serious viral infections in early childhood can also affect the respiratory system,” researcher Berber Kapiten, a pediatric intensivist at the Emma Children’s Hospital, told the broadcaster. “Now we’ve added other risk factors.”

Kaipitein stressed that the analysis shows correlations, not causes, but there are indications. “Many rental properties struggle with mold or poor ventilation. Families with lower incomes are more likely to experience financial stress, which can worsen asthma attacks. Immigration can create a language barrier or reduce access to care.”

In the Netherlands, approximately 2,300 children with severe asthma are hospitalized each year. 200 to 300 of them end up in the ICU.

The researchers identified the Haaglanden, Flevoland, Amsterdam-Amstelland, Rotterdam-Rijnmond, and Kennemerland regions as asthma hotspots. In these regions, children from low-income groups are 2.6 times more likely to be admitted to the ICU for severe asthma than children from the highest income bracket.

To determine the exact cause of this disparity, Amsterdam UMC, in collaboration with the city of Amsterdam, municipal health service GGD, and sociologists, is launching a follow-up study in people’s homes. Researchers will look at the living conditions to see if they can find a concrete link to asthma.

“Asthma is more than just a medical condition,” Kapitein stressed to RTL. “We also need to consider the child’s environment. This way, doctors and municipalities can work together to support families, for example, with damp or mold problems, and parents can receive better advice about living conditions that aggravate asthma attacks.”