The impact of severe housing stress on child asthma control and pediatric asthma caregiver quality of life (PACQOL)
MetadataShow full item record
BACKGROUND: Asthma is a chronic inflammatory disease of the airways that disproportionately affects low-income and minority children in the United States. Some studies have found a clear link between poor housing quality and exposure to allergen triggers associated with increased risk of asthma. Other studies have evaluated the relationship between stressful circumstances due to chronic illness, premature birth or violence on asthma outcomes. Psychological stress is thought to weaken the immune and neuroendocrine response making the body more vulnerable to environmental allergens. Studies have been done to assess the impact of psychological stress due to violence or the care of long term-critically ill children on increased asthma morbidity. However, asthma morbidity is not equal in all low-income and minority communities. It is possible that a form of stress - housing stress - which results from living in substandard housing conditions, may in fact provide more insight into the pathways linking indoor home exposures and stress in a way that leads to greater asthma susceptibility. Few studies have been done to assess the impact of stress due to substandard housing conditions. OBJECTIVE: To determine the impact of severe housing stress due to dilapidation, mold and a lack of housing control on child asthma control and on caregiver asthma-related quality of life. METHODS: A total of 143 children with asthma living in Boston, Massachusetts and between the ages of 4 and 18 were enrolled in the Boston Allergen Sampling Study between 2008 and 2011. Home visits were conducted to measure the levels of common allergens in the home and assess child asthma control, housing stress, perceived stress, and caregiver asthma-related quality of life. Housing stress was assessed based on resident perceptions of dilapidation, mold, and a lack of housing control; perceived stress for the caregiver was assessed using the Perceived-Stress Scale (PSS); child asthma control was assessed using Asthma Control Test (ACT) scores; and caregiver asthma-related quality of life was assessed using the Pediatric Asthma Caregiver Quality of Life (PACQOL) questionnaires. RESULTS: In a multivariate logistic regression severe housing stress was associated with 7.5 times increased odds of poor asthma control (OR = 7.51, 95%CI 2.7 to 20.79, p<0.0001) for the child and 3.0 times increased odds of poor caregiver asthma-related quality of life (OR = 3.02, 95%CI 1.37 to 6.63, p<0.006). This association was significant after adjusting for potential confounders. CONCLUSIONS: Independent of allergen exposure, the association between severe housing stress and asthma health outcomes for both the child and caregiver indicate that there is an emotional stress-based pathway directly tied to poor housing quality that poses increased risk for worse asthma health outcomes.
Showing items related by title, author, creator and subject.
Applying implementation science to improve adherence to clinical guidelines in asthma care: a public health practice dissertation to improve the utilization of asthma action plans in Tennessee Bruce, Jaime Elizabeth (Boston University, 2014)Background: Tennessee made a commitment to improve the quality of care provided to children with asthma, which affects approximately 10% Tennessee's public school population. Asthma is chronic respiratory condition that ...
Asthma-Susceptibility Variants Identified Using Probands in Case-Control and Family-Based Analyses Himes, Blanca E.; Lasky-Su, Jessica; Wu, Ann C.; Wilk, Jemma B.; Hunninghake, Gary M.; Klanderman, Barbara; Murphy, Amy J.; Lazarus, Ross; Soto-Quiros, Manuel E.; Avila, Lydiana; Celedón, Juan C.; Lange, Christoph; O'Connor, George T.; Raby, Benjamin A.; Silverman, Edwin K.; Weiss, Scott T. (BioMed Central, 2010-8-10)BACKGROUND: Asthma is a chronic respiratory disease whose genetic basis has been explored for over two decades, most recently via genome-wide association studies. We sought to find asthma-susceptibility variants by using ...
Childhood asthma resolution of environmental symptoms (CARES) during general summer camp attendance: a pilot study Griffin, Caitlin McKenna (2014)BACKGROUND: The CDC estimates that asthma affects over 7 million American children. Children that live in urban settings bear more of the asthma burden in regards to morbidity and mortality than their suburban and rural ...