Interviews with caregivers of children with asthma highlight the ways they identify and mitigate asthma triggers across different places, such as home, neighborhoods, and schools.
Asthma-related risk is tied to the physical characteristics, power dynamics, institutional policies, relationships, and social norms that shape a place, according to a new study published online ahead of print in Health and Place.
Not only is it known that that asthma disproportionately affects Black children in low-income and racially segregated communities, but structural factors also contribute to the unequal distribution of asthma. Researchers examined how caregivers to children with asthma utilize emplaced caregiving tactics to understand and respond to asthma-related risks. Emplacement is “the theory that embodied experiences and the material world are mutually informed,” the authors explained.
They interviewed 41 caregivers of children in asthma in two locations: Gainesville, FL, and St. Louis, MO. Through the research, they examined the caregivers’ emplaced knowledge, or how they identified asthma-related risk in different place, and their emplaced caregiving tactics, or how they managed the child’s risk across places.
The cities of Gainesville and St. Louis were chosen because they have high rates of pediatric asthma in low-income Black communities, as well as “patterns of racialized residential segregation” that have resulted in the Black communities in East Gainesville and North St. Louis having lower incomes. In addition, these neighborhoods have higher rates of air pollution.
The majority of caregivers were women (83%) and Black (67%) with a low socioeconomic status (78%). In addition, the majority were on Medicaid (70%). The children with asthma were mostly between the ages of 5 and 11 years (59%), followed by 12 to 17 years (44%) and finally 4 years and younger (22%).
The interviews focused on asthma-related risks in three locations:
Overall, while caregivers displayed a range of emplaced caregiving tactics, they cannot control all physical and social features that put children at risk of asthma incidents. As a result, caregivers relied on the children to manage their own asthma when they were in places, such as schools, where the caregivers could not also be present.
“Emplaced understandings of risk and caregiving can help stakeholders target both individual and structural factors when developing asthma interventions that are more consistent with families’ everyday lived experiences,” the authors wrote.