Adverse Childhood Experiences and Risk Factors Associated With Asthma Among Children in the United States: The Intersection of Sex and Race/Ethnicity

Abstract

To evaluate the association between adverse childhood experiences (ACEs) and childhood asthma. In the study, the researchers also examined the effect of race and ethnicity and sex on asthma in pediatric patients.In the study, researchers included 49 000 children between the ages of 0 and 17 years. Within the population, 51.1% were male, and 11.5% had asthma.ACEs were identified from parental report in the 2017–2018 National Survey of Children’s Health. Examples of ACEs included exposure to poverty, parental separation, parental death, incarceration, domestic abuse, neighborhood violence, alcohol and drug use, mental illness, and discrimination. The subjects were separated into 4 groups on the basis of cumulative ACE count: 0, 1, 2, and ≥3. The outcome variable was childhood asthma on the basis of parental report in the National Survey of Children’s Health. The association between ACEs and childhood asthma was examined while adjusting for confounding variables.On the basis of parental report, 42% of children with asthma had at least 1 ACE, with 9.7% having ≥3 ACEs. Compared with children without ACEs, children exposed to ≥3 ACEs had an increased odds of having asthma (adjusted odds ratio [aOR]:1.45; 95% CI: 1.15 to 1.83). In addition, non-Hispanic Black boys (aOR: 1.84; 95% CI: 1.43 to 2.36) and non-Hispanic Black girls (aOR: 1.38, 95% CI: 1.08–1.77) had increased odds of childhood asthma, when compared with non-Hispanic White boys.In the study, the researchers identified an association between ACEs and childhood asthma, especially in children with cumulative ACE exposure (≥3 ACEs).ACEs can lead to short-term and long-term health consequences. In this study, the authors establish a link between ACE exposure and childhood asthma. Better understanding of these interactions could reduce health disparities by facilitating early recognition of children at high-risk for developing asthma. In this study, the authors highlight the need for additional research to understand the biological mechanisms linking ACEs to asthma development.