TY - JOUR
T1 - Dimensions of socioeconomic status and childhood asthma outcomes
T2 - Evidence for distinct behavioral and biological associations
AU - Chen, Edith
AU - Shalowitz, Madeleine U.
AU - Story, Rachel E.
AU - Ehrlich, Katherine B.
AU - Levine, Cynthia S.
AU - Hayen, Robin
AU - Leigh, Adam K.K.
AU - Miller, Gregory E.
N1 - Publisher Copyright:
Copyright © 2016 by the American Psychosomatic Society.
PY - 2016/11/1
Y1 - 2016/11/1
N2 - Objectives The objective of this study was to investigate 2 key dimensions of socioeconomic status (SES) - prestige and resources - and their associations with immune, behavioral, and clinical outcomes in childhood asthma. Methods Children ages 9 to 17 years with a physician's diagnosis of asthma (N = 150), and one of their parents participated in this study. Children and parents completed interviews and questionnaires about SES (prestige = parent education; resources = family assets), environmental exposures, and clinical asthma measures. Spirometry was conducted to assess children's pulmonary function, and blood was collected to measure cytokine production in response to nonspecific stimulation, allergen-specific stimulation, and microbial stimulation. Results Higher scores on both dimensions of childhood SES were associated with better clinical outcomes in children (β's from |.18 to.27|, p values <.05). Higher prestige, but not resources, was associated with better home environment control behaviors and less exposure to smoke (β's from |.21 to.22|, p values <.05). Higher resources, but not prestige, was associated with more favorable immune regulation, as manifest in smaller peripheral blood mononuclear cell (PBMC) TH1 and TH2 cytokine responses (β's from -.18 to -.19; p values <.05), and smaller proinflammatory cytokine responses (β = -.19; p <.05) after ex vivo stimulation. Higher resources also were associated with more sensitivity to glucocorticoid inhibition of TH1 and TH2 cytokine production (β's from -.18 to -.22; p values <.05). Conclusions These results suggest that prestige and resources in childhood family environments have different implications for behavioral and immunological processes relevant to childhood asthma. They also suggest that childhood SES relates to multiple aspects of immunologic regulation of relevance to the pathophysiology of asthma.
AB - Objectives The objective of this study was to investigate 2 key dimensions of socioeconomic status (SES) - prestige and resources - and their associations with immune, behavioral, and clinical outcomes in childhood asthma. Methods Children ages 9 to 17 years with a physician's diagnosis of asthma (N = 150), and one of their parents participated in this study. Children and parents completed interviews and questionnaires about SES (prestige = parent education; resources = family assets), environmental exposures, and clinical asthma measures. Spirometry was conducted to assess children's pulmonary function, and blood was collected to measure cytokine production in response to nonspecific stimulation, allergen-specific stimulation, and microbial stimulation. Results Higher scores on both dimensions of childhood SES were associated with better clinical outcomes in children (β's from |.18 to.27|, p values <.05). Higher prestige, but not resources, was associated with better home environment control behaviors and less exposure to smoke (β's from |.21 to.22|, p values <.05). Higher resources, but not prestige, was associated with more favorable immune regulation, as manifest in smaller peripheral blood mononuclear cell (PBMC) TH1 and TH2 cytokine responses (β's from -.18 to -.19; p values <.05), and smaller proinflammatory cytokine responses (β = -.19; p <.05) after ex vivo stimulation. Higher resources also were associated with more sensitivity to glucocorticoid inhibition of TH1 and TH2 cytokine production (β's from -.18 to -.22; p values <.05). Conclusions These results suggest that prestige and resources in childhood family environments have different implications for behavioral and immunological processes relevant to childhood asthma. They also suggest that childhood SES relates to multiple aspects of immunologic regulation of relevance to the pathophysiology of asthma.
KW - asthma
KW - childhood
KW - immune
KW - socioeconomic status
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U2 - 10.1097/PSY.0000000000000392
DO - 10.1097/PSY.0000000000000392
M3 - Article
C2 - 27749682
AN - SCOPUS:84991447104
VL - 78
SP - 1043
EP - 1052
JO - Psychosomatic Medicine
JF - Psychosomatic Medicine
SN - 0033-3174
IS - 9
ER -