Childhood wheezing, asthma, allergy, atopy, and lung function: different socioeconomic patterns for different...

Area of Science:

• Environmental epidemiology
• Pediatric respiratory health
• Social determinants of health

Background:

• Identifying preventable asthma triggers is challenging due to disease heterogeneity.
• Understanding socioeconomic patterns of asthma phenotypes can reveal preventable exposures.
• Socioeconomic position (SEP) may influence asthma development and presentation.

Purpose of the Study:

• To identify asthma disease phenotypes sensitive to socioeconomic variation.
• To determine life-course exposures associated with socioeconomic inequalities in asthma.
• To inform public health strategies for preventing asthma disparities.

Main Methods:

• Analysis of a contemporary English birth cohort (Avon Longitudinal Study of Parents and Children, n=6,378).
• Phenotyping included asthma, atopy, wheezing, lung function, and bronchial reactivity.
• Statistical modeling to assess socioeconomic position (SEP) and exposure associations.

Main Results:

• Asthma combined with atopy showed significant socioeconomic variation.
• Low SEP children had more asthma alone (aOR=1.50) but less atopy alone (aOR=0.80).
• Tobacco smoke exposure (maternal and childhood) reduction lowered asthma alone odds in low SEP children.

Conclusions:

• Asthma disparities linked to socioeconomic factors, specifically asthma alone without atopy, are potentially preventable.
• Eliminating tobacco smoke exposure is a critical intervention to reduce socioeconomic inequalities in childhood asthma.
• Other asthma phenotypes did not show significant socioeconomic patterns related to smoke exposure.