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Parents' childhood socioeconomic circumstances are associated with their children's asthma outcomes.

ABSTRACT: BACKGROUND:Previous literature documents associations between low socioeconomic status (SES) and poor health outcomes, including asthma. However, this literature has largely focused on the effects of current family circumstances. OBJECTIVE:We sought to test an intergenerational hypothesis, that the childhood SES that parents experience will be associated with asthma outcomes in their children, independent of effects of current family SES. Second, we aimed to test whether this association is in part due to difficulties in current parent-child relationships. METHODS:This was an observational study, whereby 150 parents were interviewed about their childhood SES and their children (physician-diagnosed asthma, ages 9-17 years) were interviewed about current family stress. Asthma control was assessed by parent report and child report (primary outcome), and blood was collected from children to measure cytokine production relevant to asthma (secondary outcomes). RESULTS:To the degree that parents had lower childhood SES, their offspring showed worse asthma outcomes across multiple indicators. This included lower asthma control scores (parent and child report, Ps < .05), and greater stimulated production of TH2 and TH1 cytokines by PBMCs (Ps < .05). These associations were independent of current family SES. Mediation analyses were consistent with a scenario wherein parents with low childhood SES had current family relationships that were more stressful, and these difficulties, in turn, related to worse asthma control and greater cytokine production in children. CONCLUSIONS:These results suggest the potential "long reach" of low SES across generations, and the importance of expanding theories of how the social environment can affect childhood asthma to include characteristics of earlier generations.

SUBMITTER: Chen E

PROVIDER: S-EPMC5509526 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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Parents' childhood socioeconomic circumstances are associated with their children's asthma outcomes.

Chen Edith E Shalowitz Madeleine U MU Story Rachel E RE Ehrlich Katherine B KB Manczak Erika M EM Ham Paula J PJ Le Van V Miller Gregory E GE

The Journal of allergy and clinical immunology 20170113 3

<h4>Background</h4>Previous literature documents associations between low socioeconomic status (SES) and poor health outcomes, including asthma. However, this literature has largely focused on the effects of current family circumstances.<h4>Objective</h4>We sought to test an intergenerational hypothesis, that the childhood SES that parents experience will be associated with asthma outcomes in their children, independent of effects of current family SES. Second, we aimed to test whether this asso ...[more]

PMID: 28089871

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Project description:The management of childhood asthma is often sub-optimal. Parents and other caregivers are primarily responsible for disease management and this responsibility includes communication with health professionals. The aim of this multi-perspective qualitative study was to explore the views of children, parents and health professionals to gain insight into the approach to clinical care in the management of childhood asthma. Interviews were held with nine parent-child (6-8 years) dyads, and 13 health professionals working in primary and secondary care. Interviews were transcribed verbatim and analysed thematically. Three key themes emerged that were common to all data sets; (1) Child and parent awareness of symptoms; (2) Management and child wellbeing; and (3) Professional communication education and consultation with families. Although some children demonstrate good awareness of symptoms and appropriate use of medication, some parents expressed difficulty in identifying triggers and symptoms of asthma. Furthermore, parents lacked awareness regarding appropriate use of medication for preventing and managing symptoms of asthma. Health professionals believed that communication and education was lacking. Data from all participants suggested that consultations could be enhanced with greater emphasis on children's and parents' perceptions of asthma in the development of asthma management plans. CHILDHOOD ASTHMA:GUIDING FAMILIES THROUGH DISEASE MANAGEMENT: Both parents' and children's perceptions and understanding of childhood asthma should be considered when developing asthma management plans. The management of asthma is challenging and can result in poor disease outcomes if care is not taken. An individual's perception of their (or their child's) asthma can also affect the efficacy of treatment. Aidan Searle at the Bristol Biomedical Research Centre, UK, and co-workers, interviewed nine parent-child groups and thirteen health professionals to determine their perceptions of childhood asthma management in primary care. While some children had a strong awareness of symptoms and appropriate medication use, some parents found it difficult to identify asthma triggers and symptoms. Parents also displayed a lack of understanding of management through medication. Health professionals focused on the need for clearer information for families when guiding management of childhood asthma.

Project description:RationaleFew studies have analyzed the association of socioeconomic and sociodemographic factors with asthma related outcomes in early childhood, including Fraction of exhaled Nitric Oxide (FeNO) and airway resistance (Rint). We examined the association of socioeconomic and sociodemographic factors with wheezing, asthma, FeNO and Rint at age 6 years. Additionally, the role of potential mediating factors was studied.MethodsThe study included 6717 children participating in The Generation R Study, a prospective population-based cohort study. Data on socioeconomic and sociodemographic factors, wheezing and asthma were obtained by questionnaires. FeNO and Rint were measured at the research center. Statistical analyses were performed using logistic and linear regression models.ResultsAt age 6 years, 9% (456/5084) of the children had wheezing symptoms and 7% (328/4953) had asthma. Children from parents with financial difficulties had an increased risk of wheezing (adjusted Odds Ratio (aOR) = 1.63, 95% Confidence Interval (CI):1.18-2.24). Parental low education, paternal unemployment and child's male sex were associated with asthma, independent of other socioeconomic or sociodemographic factors (aOR = 1.63, 95% CI:1.24-2.15, aOR = 1.85, 95% CI:1.11-3.09, aOR = 1.58, 95% CI:1.24-2.01, respectively). No socioeconomic or gender differences in FeNO were found. The risks of wheezing, asthma, FeNO and Rint measurements differed between ethnic groups (p<0.05). Associations between paternal unemployment, child's sex, ethnicity and asthma related outcomes remained largely unexplained.ConclusionsThis study showed differences between the socioeconomic and sociodemographic correlates of wheezing and asthma compared to the correlates of FeNO and Rint at age 6 years. Several socioeconomic and sociodemographic factors were independently associated with wheezing and asthma. Child's ethnicity was the only factor independently associated with FeNO. We encourage further studies on underlying pathways and public health intervention programs, focusing on reducing socioeconomic or sociodemographic inequalities in asthma.

Project description:BackgroundIn the United States, due to residential segregation, racial minorities and families with low socioeconomic status (SES) tend to live in less safe neighborhoods than their White and high SES counterparts. As such, in the US, race and SES closely correlate with neighborhood safety. Due to the high chronicity of stress in unsafe neighborhoods, perceived neighborhood safety may be a mechanism through which race and SES are linked to children's mental health. Simultaneously, race and SES may alter the effects of perceived neighborhood safety on children's mental health.AimTo explore racial and SES differences in the effects of neighborhood safety on children's internalizing symptoms, we compared racially and SES diverse groups of American children for the effects of parents' perceived neighborhood safety on children's internalizing symptoms.MethodsThis cross-sectional study included 10484 children from the Adolescent Brain Cognitive Development (ABCD) study. Mixed-effects regression was used for data analysis. The predictor variable was parents' perceived neighborhood safety which was treated as a continuous measure. The primary outcome was children's internalizing symptoms reported by children. Race, parental education, household income, and family structure were moderators.ResultsOverall, the parents' high neighborhood safety was associated with lower levels of internalizing symptoms in children. Race and household income showed statistically significant interactions with subjective neighborhood safety on children's internalizing symptoms. Parents' perceived neighborhood safety showed a stronger inverse association with children's internalizing symptoms for Black than White families. Parents' perceived neighborhood safety showed a stronger inverse association with children's internalizing symptoms for high income than low-income families. Parental education or family structure did not show any significant interaction with parents' perceived neighborhood safety on children's internalizing symptoms.ConclusionThe degree to which neighborhood safety may be associated with children's internalizing symptoms may depend on race and household income. Some of the effects of race and SES on children's mental health outcomes may be due to interactions with contextual factors such as neighborhood safety. More research is needed on why and how diverse racial and SES groups differ in the association between perceived neighborhood safety and children's well-being.

Project description:ObjectiveDisadvantaged socioeconomic circumstances in early life have the potential to impact lung function. Thus, this study aimed to summarise evidence on the association between socioeconomic circumstances and respiratory function from childhood to young adulthood.DesignSystematic review and meta-analysis.MethodsFollowing the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines, Medline, ISI-Web of Science and Scopus were searched from inception up to January 2018. Original studies on the association between socioeconomic circumstances and respiratory function in early ages (ie, participants younger than 25 years of age) were investigated. Two investigators independently evaluated articles, applied the exclusion criteria, extracted data and assessed the risk of bias using the Newcastle-Ottawa Scale. A meta-analysis of the standardised mean difference and 95% CI in respiratory function between participants from different socioeconomic circumstances was conducted, using a random-effects model.ResultsThirty-three papers were included in this review and 23 showed that disadvantaged socioeconomic circumstances were significantly associated with reduced respiratory function. The meta-analysis including seven papers showed a significant difference of -0.31 (95% CI -0.42 to -0.21) litres in forced expiratory volume in the first second between children, adolescents and young adults from disadvantaged versus advantaged socioeconomic circumstances. Specifically a difference of -0.31 (95% CI -0.51 to -0.10) litres in girls and -0.43 (95% CI -0.51 to -0.35) litres in boys was observed.ConclusionsChildren, adolescents and young adults from disadvantaged socioeconomic circumstances had lower respiratory function, and boys presented higher respiratory health inequalities. This information contributes to explain the social patterning of respiratory diseases, and might enable health policy makers to tackle respiratory health inequalities at early ages.

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Parents' childhood socioeconomic circumstances are associated with their children's asthma outcomes.

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Parents' childhood socioeconomic circumstances are associated with their children's asthma outcomes.

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