Asthma, a chronic inflammatory lung disease, is one of the most disparate conditions in the United States. Asthma prevalence, morbidity, and mortality often track with race, ethnicity, and socioeconomic status because inequitable housing conditions subject low-income and marginalized communities to a range of excessive environmental exposures including pests, dust, air pollution, and molds to name a few.
In my work, I aim to gain a better understanding of asthma development and exacerbation as well as the influence of such modifiable environmental exposures on the burden of asthma.
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Trajectory analysis of rhinitis in a birth cohort from lower-income NYC neighborhoods
Published in the Journal of Allergy and Clinical Immunology, December 2023
Recognizing how understudied rhinitis is compared to asthma, I used data-driven methods to characterize the developmental trajectories of rhinitis. Using latent class mixed-models, we identified 5 rhinitis phenotypes —two of which were strongly related to adolescent asthma development.
Electrical power outages and asthma-related emergency department visits in NYC, 2019-2020
In preparation
We used NYCHA outage data to investigate the health implications of outages with minimal exposure misclassification. In tandem, we could use theNYC-wide locality data to triangulate our results. Existing power outage research links power outages to the exacerbation of respiratory conditions, but the health consequences of asthmatics –who might be vulnerable to heat, cold, or other outage-related stressors – remains underexplored.
In these two analyses, we found positive associations between power outages and asthma ED visits, highlighting the importance of considering asthmatics among those vulnerable when the power goes out.
The rise of unconventional natural gas development and the fall of coal-fired power plants: Associations with pediatric asthma onset in Pennsylvania
In preparation
As a result of regulation, lower prices, and technological advances, in 2015, natural gas surpassed coal as the primary US electricity source. During the transition from coal to natural gas, many children lived in communities dually exposed to coal-fired power plants and unconventional natural gas development (UNGD). We used 2006-2020 electronic health record data from Geisinger in Pennsylvania and longitudinal modified treatment policy (LMTP) methodology to estimate asthma incidence under hypothetical coal or UNGD interventions.
Our results demonstrated that intervention to reduce coal and UNGD exposures could reduce asthma incidence, especially among low-income individuals, who are disproportionately burdened by the adverse health effects of such exposures.
An equity-focused evaluation of a system-wide intervention to reduce mold in NYC public housing and its impact on asthma burden
Analyses forthcoming
In response to inequitable household mold exposures, multiple environmental and social justice organizations filed a class-action lawsuit on behalf of residents suffering from asthma due to NYCHA’s failure to remove mold and excessive moisture in their apartments. In response, NYCHA and the plaintiffs created what came to be known as ‘Mold Busters’– a comprehensive intervention to improve mold remediation. In September of 2023, I was awarded an F31 to assess the impact of this intervention on asthma morbidity through environmental and climate justice lenses.