Inner city children with asthma face several environmental factors that increase their risk of morbiditydue to frequent exposure of these factors such as environmental tobacco smoke, air pollutants, pesticides, and insects commonly found in inner city communities. However, in addition to these major factors, inner citycaregivers of children with asthma have similar characteristics that may contribute to the increase of asthmamorbidity in this young population. Several studies have shown similarities in inner city caregivers of childrenwith asthma such as exhibiting depressive symptoms, being highly stressed, having low education, andbeing a smoker. The majority of inner city U.S. children who are affected with asthma are of the minoritypopulation particularly of African American descent and it remains a serious problem in US inner cities. Most inner city children are of African American and according to the Centers of Disease Control andPrevention, the asthma mortality rate in black children was 7-fold higher than that of white children between2004-2005. Environmental Tobacco Smoke (ETS) exposure among children with asthma has been shown toworsen respiratory and decrease pulmonary function in children. Mothers that smoke have been shown inseveral studies to be associated with the increase of asthma morbidity in children such as excessive asthmaexacerbations which may lead to frequent emergency department visits and increased day time and nighttimesymptoms such as wheezing and coughing in children with asthma. Children are mainly exposed to ETS inthe home by parental smokers. Maternal smoking has been consistently associated with the increased risk ofwheezing in children in numerous studie3 especially in males.
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