The role of the social environment in children and adolescents with asthma

Edith Chen*, Louise S. Chim, Robert C. Strunk, Gregory E. Miller

*Corresponding author for this work

Research output: Contribution to journalArticle

88 Scopus citations

Abstract

Rationale: Biopsychosocial models of asthma have been proposed in the literature, butfew empirical tests of social factors at various levels of influence have been conducted. Objectives: To test associations of neighborhood, peer, and family factors with asthma outcomes in youth, and to determine the pathways through which these social factors operate. Methods: Observational study of youths with asthma (n 5 78). Measurements and Main Results: Youths completed questionnaires about neighborhood problems, peer support, and family support. Biological (IgE, eosinophil count, production of IL-4) and behavioral (youth smoking, exposure to smoke, adherence to medications) pathways were measured. Asthma symptoms and pulmonary function were assessed in the laboratory and at home for 2 weeks. Lower levels of family support were associated with greater symptoms (β coefficients: -0.26 to 20.33, P < 0.05) and poorer pulmonary function (β: 0.30, P < 0.05) via biological pathways (Z statistics from 1.19 to 1.51, P < 0.05). Higher levels of neighborhood problems were associated with greater symptoms (β coefficients: 0.27-0.33, P < 0.05) via behavioral pathways related to smoking (Z statistics = 1.40, P < 0.05). Peer support was not associated with symptoms or pulmonary function. Conclusions: This study indicates that family factors may affect youths' asthma via physiologic changes, whereas community factors may help shape the health behaviors of youths with asthma.

Original languageEnglish (US)
Pages (from-to)644-649
Number of pages6
JournalAmerican journal of respiratory and critical care medicine
Volume176
Issue number7
DOIs
StatePublished - Oct 1 2007

Keywords

  • Adolescents
  • Behaviors
  • Children
  • Inflammatory markers
  • Support

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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