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Racism may affect asthma control in children

Young black children whose parents or guardians reported having experienced chronic stress associated with racism may have poorer asthma control, according to data published in Annals of Allergy, Asthma and Immunology.

“The relationship between adverse childhood experiences or chronic stressors and asthma risk has been described in adult and some pediatric populations,” Bridgette L. Jones, MD, MS, an allergist and member of the American College of Allergy, Asthma and Immunology, said in a press release. “A recent policy statement from the American Academy of Pediatrics examined how racism can negatively impact the development of infants, children and teens. We wanted to focus on asthma because we know exposure to chronic or toxic stress affects the pathways that are relevant to asthma control. What hasn’t been examined is the impact of these experiences in early childhood where interventions to address the exposures may be more effective.”

To examine the link between chronic stress and child asthma control, Jones and colleagues conducted a cross-sectional pilot study of 31 parents or guardians of urban-dwelling black children aged 1 to 6 years with asthma in Kansas City, Missouri. Questionnaires were used to assess asthma control and chronic stressors, including home and caretaker instability, food insecurity, racism or discrimination, neighborhood disorder and violence, family abuse or violence, parental depression or mental health and issues related to urban life.

Overall, 47% of children had previously required hospitalization for asthma, 27% had required intensive care support during asthma hospitalization and 55% of parents or guardians reported that their children had experienced more than four adverse childhood experiences. Results demonstrated an inverse correlation between low scores on the asthma control questionnaires and stress as a result of racism (P = .02). Exposure to an increased number of chronic stressors and scores indicating housing and food insecurity were also associated with decreased asthma control in children.

“Adverse childhood experiences and toxic or chronic stressors such as emotional, physical or sexual abuse, housing instability, financial stress and experiencing racial discrimination are psychosocial factors that are associated with poor asthma control in children,” Jones said. “Knowing that’s true for older children, it’s important to identify stressors in young children that are potentially able to be modified. That could possibly allow for early intervention to improve health-related outcomes in the long term.”

The researchers acknowledged that their study was limited by its small sample size and the fact that parents or guardians were reporting exposure to stressors on behalf of the child. – by Melissa Foster

Disclosures: The authors report no relevant financial disclosures.