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Social adversity, migration and hospital admissions for childhood asthma in Sweden

A Hjern1, B Haglund, S Bremberg

  • 1Department of Clinical Sciences, Huddinge University Hospital, Karolinska Institutet, Stockholm, Sweden. anders.hjern@sos.se

Acta Paediatrica (Oslo, Norway : 1992)
|November 24, 1999
PubMed

Insights

Hospital admissions for childhood asthma are higher in socially disadvantaged families and single-parent households. Smoking during pregnancy also increases asthma admission risk in young children.

Area of Science:

  • Pediatrics
  • Public Health
  • Epidemiology

Background:

  • Childhood asthma prevalence is increasing, yet hospital admissions have decreased in Sweden.
  • Improved maintenance therapy for severe childhood asthma is a potential explanation for decreased admissions.
  • Socioeconomic and ethnic factors influencing asthma hospitalizations require further investigation.

Purpose of the Study:

  • To identify social and ethnic characteristics of children (2-18 years) requiring improved asthma disease management.
  • To analyze risk factors for hospital admission due to asthma in children.
  • To investigate disparities in asthma care and outcomes.

Main Methods:

  • Utilized Swedish National Patient Discharge Registers for hospital admissions data (Stockholm, Malmö, Gothenburg, 1990-1994).
  • Analyzed data for children aged 2-18 years, focusing on social welfare status, household structure, and ethnicity.
  • Calculated adjusted odds ratios (OR) to determine risk factors for asthma-related hospital admissions.

Main Results:

  • Children in families on social welfare and single-parent households had higher odds of asthma hospital admission (OR: 1.3-1.5).
  • Children on social welfare faced a particularly high risk of multiple annual admissions (OR: 1.6-2.9).
  • Exposure to smoking during pregnancy increased asthma admission risk in children under 3 years.
  • Children born outside Western countries, USA, and Australia, and Swedish-born children with mothers from Eastern/Southern Europe had lower asthma admission risks (OR: 0.1-0.6).

Conclusions:

  • Socially disadvantaged children, particularly those in single-parent households, require targeted asthma management strategies.
  • Prenatal smoking exposure is a significant risk factor for childhood asthma hospitalizations.
  • Ethnic variations in asthma prevalence may exist, necessitating further research into underlying factors and potential disparities in healthcare access or disease presentation.

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