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Social Vulnerability Is Associated with Poorer Outcomes in Preschool Children With Recurrent Wheezing Despite

Abby D Mutic1, David T Mauger2, Jocelyn R Grunwell3

  • 1Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Ga.

The Journal of Allergy and Clinical Immunology. in Practice
|February 5, 2022
PubMed

Insights

Social vulnerability in preschool children with recurrent wheezing is linked to more severe symptoms and exacerbations, impacting caregiver quality of life. Addressing social determinants of health is crucial for improving pediatric respiratory outcomes.

Area of Science:

  • Pediatric respiratory health
  • Social determinants of health
  • Public health

Background:

  • Social determinants of health (SDOH) impact asthma outcomes in school-aged children.
  • SDOH have not been previously studied in preschool children experiencing recurrent wheezing.

Purpose of the Study:

  • To investigate the association between social vulnerability and health outcomes in preschool children with recurrent wheezing.
  • To test the hypothesis that socially vulnerable preschoolers with recurrent wheezing experience more frequent symptoms and exacerbations.

Main Methods:

  • A multicenter study followed preschool children with recurrent wheezing receiving standardized care.
  • Children were stratified by a composite measure of social vulnerability.
  • Primary outcomes included upper respiratory infections and asthma symptom flares; secondary outcomes assessed symptom severity, exacerbations, quality of life, and hospitalizations.

Main Results:

  • Socially vulnerable preschoolers did not have more frequent infections or exacerbations.
  • However, they experienced more severe symptoms during infections and flares, and more severe exacerbations.
  • These children also faced poorer housing conditions and different exposures/triggers.

Conclusions:

  • Individual-level social determinants of health are associated with poorer outcomes in preschoolers with recurrent wheezing, even with standardized care.
  • Comprehensive assessment of SDOH is essential for young children with wheezing.
  • Mitigating social inequities is a critical step to improve pediatric respiratory health outcomes.
Abstract

Keywords:
Asthma controlAsthma exacerbationDisparitiesEnvironmental exposuresEthnicityPovertyRaceSocial determinants of healthWheeze

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