Recurrent Preschool Wheeze: The Impact of Adverse Social Drivers of Health and Opportunities for Interventions

Recurrent preschool wheeze is a highly prevalent clinical finding in children that is often triggered by viral airway infections. Children with recurrent preschool wheeze experience high rates of adverse health care utilization, such as emergency department visits and hospitalizations, posing significant burdens on both families and health care systems. Despite its common occurrence, the lack of a standardized definition limits diagnostic and management strategies, as well as understanding of the long-term trajectory of respiratory disease. Social drivers of health (SDoH), such as access to stable housing and healthy food options, play a crucial role in the incidence of recurrent preschool wheeze and possibly long-term outcomes into adolescence and adulthood. Such findings underscore the need for targeted social interventions aimed at reducing adverse outcomes in this patient cohort, such as Community Health Worker initiatives. Further investigation of the relationship of SDoH and recurrent preschool wheeze can guide such interventions to alleviate disease burden and improve long-term health outcomes for children. In this Grand Rounds Review article, we present a case of a child with recurrent preschool wheeze to illustrate the importance of elucidating the role of adverse SDoH and opportunities for interventions. This article serves as a framework for providers to identify and address adverse SDoH in children with recurrent preschool wheeze.