THE IMPORTANCE of addressing environmental exposures, social determinants of health, and risk-taking behaviors in managing childhood asthma was emphasized in a recently published study by authors from University of Colorado School of Medicine and Children’s Hospital Colorado. While traditional asthma management focuses on therapeutic interventions, this comprehensive approach aims to reduce health disparities and promote health equity.
The study highlights that common asthma therapies, such as bronchodilators and anti-inflammatory medications, primarily target T2-high airway inflammation. However, limited options exist for controlling other inflammatory features contributing to asthma, particularly in cases with T2-low airway inflammation. Environmental factors, including exposure to allergens and pollutants, social determinants like housing quality and access to healthcare, and behaviors such as risk-taking, may underlie asthma persistence, progression, and comorbidities.
To effectively manage these non-pharmacologic aspects, the study advocates for a shared decision-making approach involving patients and their caregivers. This strategy encompasses asthma education, care coordination, environmental control, and consideration of climate events that can exacerbate asthma symptoms. By integrating these factors into asthma management plans, healthcare professionals can better address the diverse needs of pediatric patients.
The study also underscores the dynamic nature of asthma, which can manifest differently across individuals—from transient wheezing to persistent asthma requiring ongoing management. Understanding the heterogeneous molecular pathways (T2, T1, T17) and their environmental drivers (viruses, allergens, pollutants) is crucial for providing targeted care.
In summary, this research calls for a holistic approach to childhood asthma management that goes beyond pharmacologic treatments. By considering environmental, social, and behavioral factors, healthcare professionals can work towards achieving health equity and improving outcomes for children with asthma.
Reference: Skeen E et al. Managing Childhood Asthma with an Eye Toward Environmental, Social and Behavioral Features. Ann Allergy Asthma Immunol. 2025;S1081-1206(25)00092-4.
Anaya Malik | AMJ
