Neighborhood-Level Factors Related to Asthma in Children Living in Urban Areas: An Integrative Literature Review

Asthma disproportionately affects children who are non-White and of low socioeconomic status. One innovative approach to address these health disparities is to investigate the child’s neighborhood environment and factors influencing asthma symptoms. The purpose of this integrative review is to critique research investigating the relationships between neighborhood-level factors and asthma morbidity in urban children. Three literature databases were searched using the terms “asthma,” “child,” “neighborhood,” and “urban.” The articles included were organized into six themes within the larger domains of prevalence, physical, and social factors. Literature tables provide in-depth analysis of each article and demonstrate a need for strengthening analysis methods. The current research points to the necessity for a multilevel study to analyze neighborhood-level factors that are associated with increased asthma morbidity in urban children. School nurse clinicians, working within children’s neighborhoods, are uniquely positioned to assess modifiable neighborhood-level determinants of health in caring for children with asthma.