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Observational Study
. 2017 Sep;140(3):828-835.e2.
doi: 10.1016/j.jaci.2016.11.040. Epub 2017 Jan 13.

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

Edith Chen  1 , Madeleine U Shalowitz  2 , Rachel E Story  2 , Katherine B Ehrlich  3 , Erika M Manczak  3 , Paula J Ham  3 , Van Le  3 , Gregory E Miller  3
Affiliations
Observational Study

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

Edith Chen et al. J Allergy Clin Immunol. 2017 Sep.

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.

Keywords: Socioeconomic status; asthma; childhood; family stress.

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Conflict of interest statement

Conflicts of Interest: All authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Children’s asthma control by parents’ childhood SES (cSES). Bars are shown by both child report on the Asthma Control Test, as well as parent report on the Asthma Control Test.
Figure 2
Figure 2
Parents’ childhood SES (cSES) and children’s cytokine production in response to stimulation with PMA/INO (25ng/mL/1ug/mL). Bars are shown for both Th1 and Th2 cytokine responses. Cytokine values are standardized and aggregated into composites.
See this image and copyright information in PMC

Comment in

  • Asthma: The past, future, environment, and costs.
    Shemesh E, Kleinman LC. Shemesh E, et al. J Allergy Clin Immunol. 2017 Sep;140(3):688-689. doi: 10.1016/j.jaci.2017.03.031. Epub 2017 Apr 20. J Allergy Clin Immunol. 2017. PMID: 28433690 No abstract available.

References

    1. Adler NE, Rehkopf DH. U.S. disparities in health: descriptions, causes, and mechanisms. Annu Rev Public Health. 2008;29:235–252. - PubMed
    1. Marmot M, Wilkinson RG. Social determinants of health. New York, NY: Oxford University Press; 2000.
    1. Chen E, Matthews KA, Boyce WT. Socioeconomic differences in children’s health: How and why do these relationships change with age? Psychological Bulletin. 2002;128:295–329. - PubMed
    1. Schreier HM, Chen E. Socioeconomic status and the health of youth: a multilevel, multidomain approach to conceptualizing pathways. Psychol Bull. 2013;139(3):606–654. - PMC - PubMed
    1. Maziak W, von ME, Keil U, et al. Predictors of health care utilization of children with asthma in the community. Pediatric Allergy and Immunology. 2004;15(2):166–171. - PubMed

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