When Elizabeth Matsui, M.D., MHS, and her team published a 2021 research study on the prevalence of childhood asthma in Travis County, the findings splashed across headlines: Hospitalizations for pediatric asthma were 60% higher in the county than for U.S. children overall — and residents from the lowest-income, most racially segregated neighborhoods were experiencing more emergency room visits and hospitalizations than anyone.
Now, the question: Why? What’s causing eight times as many Black children and 2.5 times as many Latino/a/x children to be hospitalized for asthma as white children in the region? Matsui and her multidisciplinary research are working to characterize the actual source of local air pollution leading to hospitalizations.
As of 2021, 16 out of every 10,000 kids younger than 18 in Travis County were hospitalized for asthma per year, compared with about 10 out of 10,000 children elsewhere.
“What we don’t yet know is whether urban planning and zoning decisions — which influence the location of air pollution sources — affect the level of air pollution in a community and whether that is what is putting kids who live in that neighborhood at greater risk,” says Matsui, professor in the departments of Population Health and Pediatrics at Dell Medical School.
The built environment — highways, parks, public buildings, private homes and more — shapes communities: In Travis County, when a map of asthma-related emergency room visits is overlaid on a census tract displaying the location of Black and Latino/a/x residents, the relationship between residents’ racial backgrounds, neighborhood income levels and asthma rates is apparent.
But what that relationship doesn’t indicate, and what the research team will investigate with the support of a $2.6 million grant from the National Institutes of Health, is whether the air pollution is higher in these areas because the sources of pollution are located directly in these neighborhoods — like landfills, power plants or highways — or if those air pollutants came from elsewhere.
“A core aspect of the work is really about identifying how segregation impacts these neighborhoods,” says Catherine Cubbin, Ph.D., professor and associate dean for research at the Steve Hicks School of Social Work, and an investigator on the study team. “In this particular case, we’re looking at air pollution sources and their impact on asthma overall. But we are also looking at the disparity — trying to put that all together and understand the story of how these places came to be.
Assembling the Right Team for the Job
Painting an accurate picture of exactly how and why local environments influence health requires a unique team — statisticians, urban planners, physician-scientists and policy professionals, among others — to break the question down.
As the founder of the Center for Health and Environment: Education and Research, or CHEER, Matsui is uniting a hub of researchers anchored at Dell Med, all working across disciplines to develop evidence-based solutions to meaningfully reduce disparities and improve health on both a local and global scale.
And for a study of this breadth and depth, arriving at sound recommendations takes years and requires expertise from fields that are not customarily involved in medical studies.
“I can tell them that I think something is bad for people’s health, but I’m not a medical professional. So I can’t make that connection in the way that others can,” says study investigator Elizabeth Mueller, Ph.D., professor in UT’s School of Architecture who studies economic and racial segregation in city planning. “By having someone here on campus as a partner who is, in fact, a physician-scientist, then we can make that connection and advance solutions together.”