P4.061: Estimating pediatric asthma burden in New Orleans, Louisiana as part of the Allergen Reduction and Child Health Study (ARCHS)

Background: Asthma is a common chronic disease among children in the United States, affecting an estimated 6.7% of children under the age of 18 (1). Interventions to improve asthma outcomes should be targeted to populations at greatest risk for asthma exacerbations. In New Orleans, Louisiana, the burden of asthma has not been well documented. The Allergen Reduction and Child Health Study (ARCHS) is an ongoing comparative effectiveness study of two interventions known to improve asthma severity.
Participant recruitment is an ongoing challenge in urban studies. Insight into geographical asthma hotspots would help identify areas with potentially high burdens of pediatric asthma and would help guide recruitment of at-risk children.

Methods: To assess the burden of asthma, we reviewed the electronic medical records (EMR) of children aged 5-17 years who presented to the emergency room (ER) at Manning Family Children’s Hospital, a leading pediatric ER in Greater New Orleans, and were diagnosed with an asthma exacerbation (ICD-10-CM: J45) between January 2020 - January 2025. Inclusion criteria included age, asthma diagnosis, and current residence in New Orleans. Home addresses were geocoded and mapped to the 849 census tracts using QGIS spatial visualization software.

Results: Of the 1,469 unique patients presenting within the sample period, we identified 8 total census tract areas demonstrating the highest number of patients with uncontrolled asthma. 75% of these tracts (n=6) can be found in just one neighborhood of the city, New Orleans East. This neighborhood was identified as a potential asthma hotspot, as demonstrated by higher concentrations of patients, as seen in Figure 1.

Conclusion: Although it has long been acknowledged that the prevalence of asthma is high among children living in poor urban neighborhoods in the U.S., the prevalence of asthma in these neighborhoods is not well described in New Orleans (2,3). Our results demonstrate several geographic areas where asthma ER visits are high. Identifying the factors associated with greater asthma burden, including differences in access to preventive care, should be examined so that interventions can be directed to populations with greatest need.

1. National Center for Health Statistics. (2023). Percentage of ever having asthma for children under age 18 years, United States, 2019-2023. National Health Interview Survey. https://wwwn.cdc.gov/NHISDataQueryTool/SHS_child/index.html
2. Grant TL, Wood RA. The influence of urban exposures and residence on childhood asthma. Pediatr Allergy Immunol. 2022 May;33(5):e13784. doi: 10.1111/pai.13784. PMID: 35616896; PMCID: PMC9288815.
3. Keet CA, McCormack MC, Pollack CE, Peng RD, McGowan E, Matsui EC. Neighborhood poverty, urban residence, race/ethnicity, and asthma: Rethinking the inner-city asthma epidemic. J Allergy Clin Immunol. 2015 Mar;135(3):655-62. doi: 10.1016/j.jaci.2014.11.022. Epub 2015 Jan 20. PMID: 25617226; PMCID: PMC4391373.