Social and environmental stressors in the home and childhood asthma
- 1 Harvard School of Public Health, United States;
- 2 Columbia University, United States;
- 3 Boston University School of Medicine, United States;
- 4 The Beth Israel Deaconess Medical Center, United States
- Correspondence to: Shakira Franco Suglia, Boston University, 88 East Newton St, Vose Hall 3, Boston, MA, 02118, United States; shakira.suglia{at}bmc.org
- Received 17 October 2008
- Accepted 24 September 2009
- Published Online First 14 October 2009
Abstract
Objectives: Both physical environmental factors and chronic stress may independently increase susceptibility to asthma; however, little is known on how these different risks may interact. We 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 (i.e., peeling paint, holes in floor, broken windows) and housing disarray (i.e., dark, cluttered, crowded or noisy house). At the same time, mothers reported on housing hardships (i.e., 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 adjusted analysis, an increased odds of asthma was observed in children of mothers experiencing IPV chronically (OR 1.8, 95% CI 1.0, 3.5) and in children experiencing housing disarray (OR 1.5, 95% CI 1.1, 2.0) compared to 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 (i.e. IPV and poor housing quality) may increase children’s risk of developing asthma more than a single stressor.
