Family relationships and structure are linked to asthma control in low-income children, according to two new studies.
One team of researchers analyzed the intersection of neighborhood conditions, family relationships and asthma among 308 youths ages 9-17 years in the Chicago area. It gathered data using interviews, questionnaires, spirometry and blood draws. Neighborhood quality was assessed using Google Street View.
The study found children in neighborhoods with higher levels of danger or disorder had worse asthma outcomes, including activity limitations and poorer response to symptoms, according to “Neighborhood Social Conditions, Family Relationships, and Childhood Asthma,” (Chen E, et al. Pediatrics. July 18, 2019, https://doi.org/10.1542/peds.2018-3300).
When children in these neighborhoods had good family relationships, they had fewer activity limitations, fewer symptoms, better responses to symptoms from both the child and family and better lung function.
“For children with asthma, this may mean parents prioritize asthma management and teach their children how to stay focused on maintaining their health … regardless of what is going on in their neighborhood,” authors wrote.
Family relationships were not linked to asthma for those in less dangerous neighborhoods. Family relationships also weren’t linked to cytokine production.
In another new study, family chaos was linked to poor asthma control.
Researchers used randomized trial data on 223 low-income 5- to 16-year-olds with uncontrolled asthma who lived in the Chicago area. Caregivers answered questions about family functioning and mental health during interviews and on questionnaires.
Results showed parent and child depression symptoms and family chaos were independently linked to poor asthma control. In a model combining parent, child and family predictors, only family chaos significantly predicted asthma control, according to “Family Chaos and Asthma Control,” (Weinstein SM, et al. Pediatrics. July 9, 2019, https://doi.org/10.1542/peds.2018-2758).
“Parents with depressive symptoms may experience executive functioning deficits and high levels of stressors that interfere with the establishment of consistent routines, stability, and organization in the home that are essential for asthma management,” authors wrote.
The team also found family chaos mediated the relationship between parent depression and asthma control. They did not see strong relationships between post-traumatic stress disorder or social support and asthma control.
“Addressing parent and child depression, family routines, and predictability may optimize asthma outcomes,” authors said.