Social and environmental stressors in the home and childhood asthma

Abstract

Background: Both physical environmental factors and chronic stress may independently increase susceptibility to asthma; however, little is known on how these different risks may interact. The authors examined the relationship between maternal intimate partner violence (IPV), housing quality and asthma among children in the Fragile Families and Child Wellbeing Study (N=2013).

Methods: Maternal reports of IPV were obtained after the child's birth and at 12 and 36 months. At the 36-month assessment, interviewers rated indoor housing conditions, regarding housing deterioration (ie, peeling paint, holes in floor, broken windows) and housing disarray (ie, dark, cluttered, crowded or noisy house). At the same time, mothers reported on housing hardships (ie, moving repeatedly, and hardships in keeping house warm). Maternal-report of physician-diagnosed asthma by age 36 months which was active in the past year was the outcome.

Results: Asthma was diagnosed in 10% of the children. In an adjusted analysis, an increased odds of asthma was observed in children of mothers experiencing IPV chronically (OR 1.8, 95% CI 1.0 to 3.5) and in children experiencing housing disarray (OR 1.5, 95% CI 1.1 to 2.0) compared with those not exposed to these risks. In stratified analyses, a greater effect of IPV on asthma was noted among children living in disarrayed or deteriorated housing or among children whose mothers were experiencing housing hardship.

Conclusions: IPV and housing disarray are associated with increased early childhood asthma. Exposure to cumulative or multiple stressors (ie, IPV and poor housing quality) may increase children's risk of developing asthma more than a single stressor.

Figure 1. Odds of child asthma by maternal intimate partner violence stratified by housing deterioration

Adjusted for child’s age, gender, race/ethnicity, maternal education, marital status, public assistance, mother’s use of asthma medication, tobacco exposure and low birth weight

Figure 2. Odds of child asthma by maternal intimate partner violence stratified by housing disarray

Adjusted for child’s age, gender, race/ethnicity, maternal education, marital status, public assistance, mother’s use of asthma medication, tobacco exposure and low birth weight

Figure 3. Odds of child asthma by maternal intimate partner violence stratified by housing hardship

Adjusted for child’s age, gender, race/ethnicity, maternal education, marital status, public assistance, mother’s use of asthma medication, tobacco exposure and low birth weight