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Social and environmental stressors in the home and childhood asthma
  1. Shakira Franco Suglia1,
  2. Cristiane S Duarte2,
  3. Megan T Sandel1,
  4. Rosalind J Wright3,4
  1. 1Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts, USA
  2. 2Division of Child and Adolescent Psychiatry, Columbia University, New York, USA
  3. 3Channing Laboratory, Department of Medicine, Brigham & Women's Hospital/Harvard Medical School, Boston, Massachusetts, USA
  4. 4Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA
  1. Correspondence to Dr Shakira Franco Suglia, Department of Pediatrics, Boston University School of Medicine, 88 East Newton Street, Vose Hall 3, Boston, MA 02118, USA; shakira.suglia{at}


Background Both physical environmental factors and chronic stress may independently increase susceptibility to asthma; however, little is known on how these different risks may interact. The authors 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 (ie, peeling paint, holes in floor, broken windows) and housing disarray (ie, dark, cluttered, crowded or noisy house). At the same time, mothers reported on housing hardships (ie, 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 an adjusted analysis, an increased odds of asthma was observed in children of mothers experiencing IPV chronically (OR 1.8, 95% CI 1.0 to 3.5) and in children experiencing housing disarray (OR 1.5, 95% CI 1.1 to 2.0) compared with 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 (ie, IPV and poor housing quality) may increase children's risk of developing asthma more than a single stressor.

  • Intimate partner violence
  • asthma
  • housing quality
  • built environment
  • children
  • housing
  • violence RB

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  • Funding Support was provided by the Robert Wood Johnson Foundation New Connections Initiative Award SFS and CSD and NIH T32MH073122-04 (SFS), K23 ES013173-05 (MTS) and by U01 HL072494 and R01 HL080674 (RJW). The Fragile Families and Child Wellbeing Study was supported by R01HD36916 from the National Institute of Child Health and Human Development.

  • Competing interests None.

  • Ethics approval Institutional Review Panels at Princeton University and Columbia University have provided the requisite ethics approvals for the Fragile Families and Child Wellbeing Study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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