Research & Projects

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African American and Latino children experience an excess of asthma morbidity. Why?

Asthma prevalence in Puerto Rican and African American children is about double that of European and Mexican American children. However, Mexican Americans, along with African Americans and Puerto Ricans experience an excess of asthma-related symptoms, missed school days, and unplanned health care visits over their Caucasian counterparts. Variations in asthma prevalence and morbidity among subpopulations suggest it is a heterogeneous disease with varied risk profiles.

We must further evaluate these risks and the mechanisms by which they act in order to develop individualized, targeted therapies to improve asthma-related outcomes. We examine how the interaction among social, environmental, and genetic factors affect asthma outcomes in different populations. Evidence of a gene-environment interaction can be observed when the combined effect of genetic and environmental exposures increases asthma risk beyond what would be expected based on the individual exposures. Our group’s work is improving the accuracy and precision in which the assessment of genetic, social, and environmental influences of this common disease.

Jennifer Elhawary

Social, environmental, and genetic factors considered in the statical models of asthma.

Genetic research projects

Genetic research projects focus on identifying genetic risk factors and developing novel therapeutic targets for asthma. Our lab integrates multiple forms of -omics data such as whole-genome sequencing (WGS) data,  RNA sequencing (RNAseq) data, genetic ancestry data, and epigenetic (methylation) data to discover genetic determinants of asthma outcomes in the populations most affected by asthma. Methods include:

  • Genome-wide association studies (GWAS) of asthma and related traits
  • Admixture mapping scans of asthma, related traits, and drug response
  • Whole-genome sequencing studies and functional analyses
  • RNA sequencing studies and functional analyses
  • Studies that examine the influence of genetic ancestry in asthma susceptibility and lung function
  • Mediation analyses to understand how methylation can act as a genomic bridge between socio-environmental exposures and asthma outcomes


Social research projects

Social research projects examine the effects of social stressors to better understand how they influence disease and to identify which of these stressors can be changed to improve health. We have detailed information on socioeconomic status (SES), experiences of discrimination, and acculturation. Using participants' geocoded residential addresses since birth, we are also able to examine how neighborhood-level social stressors such as crime and poverty influence asthma disease, lung function, and drug response. In the UCSF Asthma Collaboratory, we focus on three major categories of social stressors.

  • Social adversities: the effects of socioeconomic status and discrimination on asthma risk and severity
  • Allostatic load: the effects of social stressors on disease risk and severity
  • Acculturation: the effects of acculturation on disease risk and severity

health model.

Health Model of Asthma and Social Adversities. Adapted from Lifecourse Health Development Model (Halfon, 2002) and the Toxic Stress Model (Center on the Developing Child, 2014).

Environmental research projects

Environmental research projects identify populations at increased risk for asthma and find potential targets for public health interventions. We have a rich database of measures of early-life environmental exposures such as daycare attendance, prenatal and current smoke exposure, family structure, diet, as well as a complete history of air pollution exposure from birth using participants' geocoded residential addresses.