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Published on: August 7, 2017
Association between adverse childhood experiences in the home and pediatric asthma
Robyn Wing1, Annie Gjelsvik2, Mariann Nocera3
1Departments of Emergency Medicine and Pediatrics, Section of Pediatric Emergency Medicine, Brown University/Hasbro Children's Hospital, Providence, Rhode Island; Warren Alpert Medical School of Brown University/Hasbro Children's Hospital, Providence, Rhode Island; School of Public Health, Brown University, Providence, Rhode Island.
Insights
Childhood adversity, or adverse childhood experiences (ACEs), significantly increases the risk of pediatric asthma. Higher numbers of ACEs correlate with greater odds of developing asthma, particularly in Hispanic children.
Area of Science:
- Pediatric Health
- Psychosocial Epidemiology
- Environmental Health
Background:
- Psychosocial factors are increasingly recognized as contributors to pediatric asthma development.
- Adverse Childhood Experiences (ACEs), a measure of household dysfunction, represent a significant area of study in child health.
Purpose of the Study:
- To investigate the association between single and cumulative ACEs and parent-reported lifetime asthma in children.
- To explore the impact of household dysfunction on childhood asthma prevalence.
Main Methods:
- Cross-sectional study utilizing data from the National Survey of Children's Health (2011-2012).
- Analysis included 92,472 children aged 0-17 years.
- Multivariable logistic regression examined the relationship between 6 ACE exposures and childhood asthma, controlling for covariates.
Main Results:
- Overall asthma prevalence was 14.6%, with 29.2% of children reporting at least one ACE.
- Increased ACE exposure was significantly associated with higher odds of childhood asthma.
- Hispanic children with 4 ACEs showed a 4.46-fold increased odds of asthma compared to those with no ACEs.
Conclusions:
- Findings support the biopsychosocial model of asthma, highlighting the role of early life adversity.
- Further research is warranted to explore the link between ACEs and specific asthma-related health outcomes.
Background:
Numerous studies suggest that psychosocial factors could contribute to pediatric asthma.
Objective:
To examine the relation between single and cumulative adverse childhood experiences (ACEs), a measurement of household dysfunction, on parent report of lifetime asthma in children.
Methods:
This cross-sectional study used data from the 2011 to 2012 National Survey of Children's Health, a nationally representative sample of children 0 to 17 years old (n = 92,472). The main exposure was parent or guardian report of 6 ACE exposures (eg, witnessing domestic violence). The relation between ACE exposures and parent-reported diagnosis of childhood asthma was examined using multivariable logistic regression after controlling for demographic, socioeconomic, and behavioral covariates.
Results:
Overall asthma prevalence was 14.6%. Exposure prevalence to any ACE was 29.2%. Increased number of ACE exposures was associated with increased odds of asthma. In the adjusted model, the odds of reporting asthma were 1.28 (95% confidence interval [CI] 1.14-1.43) for those reporting 1 ACE, 1.73 (95% CI 1.27-2.36) for those with 4 ACEs, and 1.61 (95% CI 1.15-2.26) for those with 5 or 6 ACEs compared with those with no ACE exposures. Effects were moderated by Hispanic ethnicity. Hispanic children exposed to 4 ACEs had a 4.46 times increase in lifetime asthma (95% CI 2.46-8.08); white children had a 1.19 times increase (95% CI 0.80-1.79) compared with those exposed to 0 ACE.
Conclusion:
This study supports the growing evidence for the biopsychosocial model of asthma onset. Future studies should examine the association between ACEs and specific asthma-related health outcomes.
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