Primary Prevention of Asthma: Research and Policy Implications

In many parts of the US, asthma rates continue to increase, resulting in a substantial societal burden of human suffering, lost capacity and productivity, and direct fiscal costs. As with other chronic diseases, far more resources focus on managing asthma in people who have it than on preventing the disease. There remains an urgent need to better understand the root causes of asthma and to develop strategies for reducing the rate of new cases.

A growing body of research documents associations between asthma onset and a range of risk factors, many of which are modifiable, such as exposure to contaminants and allergens in indoor air, maternal health, including stress associated with poverty and racism, as well as obesity, outdoor air pollution, traffic, and occupational chemicals. Several studies have demonstrated reduced rates of new onset asthma among recipients of an intervention to address multiple risk factors as compared to a control group. A review of these studies suggests that a more systemic, multi-factorial approach may be effective.

What could a state concerned about asthma prevalence do to reverse rates over time? For which risk factors is the weight of the evidence strong, indicating a known association between exposure and asthma onset? Where there remain uncertainties about the strength of the science, what other considerations might justify action to modify one or more risk factors? What kinds of interventions would align best with an understanding of asthma development as a complex, multi-factorial process?

On June 18th, 2013, the Collaborative on Health and the Environment (CHE) hosted a webinar to explore these science and policy questions with three people who have been involved in a groundbreaking effort to develop a “roadmap” for the primary prevention of asthma:

  • Polly Hoppin, Research Professor and Program Director at the Universityof Massachusetts, Lowelland the LowellCenterfor Sustainable Production
  • Ted Schettler, CHE’s Science Director
  • David Kriebel, Professor of Work Environment and the University of Massachusetts, Lowell.

A recording of the webinar and background materials are now available online.