National Survey Of Children's Health Research Articles

Association of neighborhood parks with child health in the United States

BACKGROUND AND AIM: While there is evidence that parks support pediatric health, there have been no national studies looking at both physical and mental health. We assessed whether the presence of a neighborhood park is associated with pediatric physical or mental health or health behaviors across the wider United States. METHODS: Hypotheses about child health and neighborhood parks were investigated among respondents to the National Survey of Children’s Health (NSCH) 2016, a nationally representative sample of children and adolescents aged 0-17. Caregivers reported on the presence of parks or playgrounds in the neighborhood and diverse outcomes, including child physical activity, screen-time, sleep, weight, and diagnosis of anxiety, depression, or attention deficit/hyperactivity disorder (ADHD). Covariates included child and family socio-demographics and, for 29 states, neighborhood urbanicity. RESULTS:Caregivers reported on 49,146 children (mean age 9.4 years; 49% female). There were 11,791 (24%) children living in neighborhoods lacking a park; children in non-urban locations (aOR 2.19, 95%CI 1.40–1.67) or below the federal poverty level (aOR = 1.48, 95%CI 1.38–1.58) had higher odds of lacking a park. Irrespective of socio-demographics, children lacking parks were more likely to be physically inactive (aOR1.36, 95% CI 1.24, 1.48), have excessive screen-time (aOR = 1.19, 95% CI 1.14, 1.25), or obtain inadequate sleep (aOR = 1.23, 95% CI 1.18, 1.29). Children without parks were more likely obese (aOR = 1.32, 95% CI 1.21, 1.43), overweight (aOR 1.25, 95%CI 1.17, 1.33), or diagnosed with ADHD (aOR 1.20, 95% CI 1.12,1.29), but not more anxious or depressed (aOR = 1.04, 95%CI 0.97, 1.11). CONCLUSIONS:Associations between parks and pediatric physical and mental health and health behaviors suggests that the provision of neighborhood parks could represent a low-cost childhood health intervention. KEYWORDS: Built environment, Green space, Children's environmental health, Mental health outcomes, Environmental disparities

Neighborhood Characteristics and Childhood Asthma: Evidence from the National Survey of Children’s Health, 2016-2017

BACKGROUND AND AIM: Although several asthma-related risk factors have been identified, there is a paucity of information on the effects of neighborhood characteristics on childhood asthma in the U.S. We examined the association between asthma and neighborhood characteristics in the U.S. using the National Survey of Children’s Health (NSCH) data. METHODS: We used aggregated data from children aged 0 to 17 years (N = 66,037) which were obtained from the 2016-2017 NSCH cycle. We computed weighted descriptive statistics and multivariable logistic regression to determine the association between current asthma status and the presence of: 1) neighborhood detractors (litter or garbage, poorly kept or rundown housing, and vandalism) and 2) neighborhood amenities (sidewalks or walking paths, parks or playground, recreation center and library or bookmobile). All analyses were performed using SAS. RESULTS:About 7.93% current asthma prevalence was reported and boys had higher odds of asthma (AOR= 1.32, 95% CI= 1.16 – 1.51) compared to girls. Children who lived in neighborhoods with at least one amenity had lower odds of asthma (AOR= 0.86, 95% CI= 0.75 – 0.99) compared to those who lived in neighborhoods with no amenities. Those who lived in neighborhoods with any detractors had higher odds of asthma (AOR= 1.20, 95% CI= 1.04 – 1.40) compared to those that lived in neighborhoods without any of these elements. CONCLUSIONS:Our findings illustrate that the neighborhood characteristics are important risk factors for asthma. Childhood asthma should be studied using environmental justice and system analysis frameworks to identify environmental risk factors that could be modified to alleviate current asthma rates in children. KEYWORDS: asthma, neighborhood detractors, neighborhood amenities, neighborhood characteristics

Sitting on the Sidelines: Disparities in Social, Recreational, and Community Participation Among Adolescents with Autism Spectrum Disorder.

Participation in extracurricular activities and community involvement during secondary school is important for the healthy social, emotional, mental, and physical development of adolescents, especially those with autism spectrum disorder (ASD). The current study utilized three waves of data (2016, 2017, and 2018) from the National Survey of Children's Health (NSCH) to examine disparities in extracurricular participation among 12- to 17-year old adolescents with ASD. Across the three waves, data demonstrate clear sociodemographic disparities among adolescents with ASD. These disparities were more evident in adolescents with caregivers that had less education and lower household income, as well as males. These disparities suggest a continued need for targeted interventions to promote engagement among adolescents with ASD to narrow this social disparity gap.

Behavioral and mental health problems in adolescents with ADHD: Exploring the role of family resilience

BackgroundFamily resilience and its role in behavioral and mental health problems has not been well documented among U.S. adolescents, especially those with ADHD. MethodsUsing data from the 2016 and 2017 National Survey of Children's Health (NSCH), we examined associations between family resilience connection index (FRCI) and conduct problems, depression, anxiety, and substance abuse in adolescents with ADHD aged 11–17 (n=4,169). Data were analyzed using multivariate logistic regression and chi-square tests. ResultsAdolescents with ADHD who had a lower FRCI score were more likely to have conduct problems (OR:1.64, CI:1.13–2.38) and depression (OR: 3.08, CI: 2.12–4.49). There were small differences between adjusted and unadjusted odds after controlling for adverse childhood experience and other covariates. LimitationWe could not assert prediction or causation, only associations among variables, due to the cross-sectional design of the 2016–2017 NSCH; however, a major advantage of the NSCH is that it includes a nationally representative sample of children and allows inferences to be made for understanding of the adolescents with ADHD in the U.S. ConclusionFindings suggest that family resilience may serve as a protective factor that leads to decreasing conduct problems, despite experiencing adversity in childhood. Targeting family resilience, in terms of teaching families ways to cope with adversities such as: a child's diagnosis of ADHD; behavioral problems, and/or other adverse experiences in children's environments, has great potential to reduce adolescents’ conduct and mental health problems.

The effect of violence in childhood on school success factors in US children

BackgroundA robust literature-base on adverse childhood experiences (ACEs) provides strong evidence on the relationships between social adversity in childhood and the health and well-being of individuals across the lifespan. One form of social adversity, exposure to violence in childhood, is not only harmful to a child's health and well-being, but detrimental to their performance in school. Poor performance in school may affect educational attainment later in life and hinder a child's upward social mobility. We focus on the impact of violence-related ACEs on school success factors to add new evidence on how violence in childhood affects a child's educational progress. ObjectiveTo examine the impact of violence-related ACEs on school success factors, including grade repetition, school absence, and school-home contact. Participants and settingsThis study uses secondary data analysis of a nationally representative survey, the National Survey of Children's Health (NSCH), to study a sample of non-institutionalized children aged 6–17 in the US (n = 35,122). MethodsWe employed binary logistic regression and multinomial logistic regression using 95% confidence intervals to analyze the effect of violence in childhood on three school success factors, controlling for socio-demographic and health status characteristics. ResultsWe found that violence in childhood increases the likelihood of grade repetition (OR = 1.47, 95% CI, 1.12–1.92), school-home contact (OR = 2.20, 95% CI, 1.86–2.60), and school absence greater than one week (OR=1.4, 95%CI,1.08-2.00; OR=1.86, 95%CI, 1.36–2.60), controlling for socio-demographic and health status characteristics. ConclusionsViolence in childhood has a statistically significant negative impact on each of the school success factors included in this study.

Duration of breast feeding and attention-deficit/hyperactivity disorder in United States preschool-aged children

BackgroundAttention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by difficulties sustaining attention and controlling hyperactivity and impulsive behavior. Population-based studies concerning the association between breast-feeding duration and ADHD among preschool-aged children in the United States (U.S.) have been sparse. AimsTo determine whether there is an association between the duration of breast feeding and ADHD in U.S. children aged 2–5 years. Methods and proceduresWe used nationally representative data from the 2016, 2017, and 2018 National Survey of Children’s Health (NSCH) to examine the association between breast-feeding duration and ADHD in U.S. preschool-aged children. Sample characteristics were compared using Rao-Scott chi-square test, and adjusted prevalence odds ratios and 95 % confidence intervals were estimated using unconditional logistic regression. Outcomes and resultsOf the 20,453 children eligible for our study, 1.5 % had received a diagnosis of ADHD and 77.5 % were reported to have been fed human milk as infants. Prevalence odds of ADHD were 57 % lower among children fed human milk for 6–12 months compared to children never fed human milk after controlling for potential confounders. Among children with durations of breast feeding lasting less than 6 months or lasting 12 months or longer, prevalence odds of ADHD were not significantly lower than the comparison group, children who were never fed human milk, after controlling for potential confounders. Conclusions and implicationsWe noted an inverse association between breast feeding durations of 6–12 months and parent-reported diagnosis of ADHD in preschool-aged children in the U.S. Future studies should use longitudinal designs to examine ADHD and duration of breast-feeding measures.

Relations among co-occurring psychopathology in youth with autism spectrum disorder, family resilience, and caregiver coping

BackgroundCo-occurring mental health problems are common in youth with autism spectrum disorder (ASD) and are associated with greater caregiver stress; however, it is not known whether such challenges overwhelm caregivers’ ability to cope. Research has demonstrated that families of children with ASD are able to demonstrate resilience; yet, whether family resilience functions as a compensatory or protective factor in ASD families has not been investigated. This study aimed to examine the relations among family resilience, co-occurring psychopathology in youth with ASD, and caregiver coping. MethodData from this study were obtained from the 2016–2018 National Survey of Children’s Health (NSCH). Multiple binary logistic regression was run to examine the associations among commonly co-occurring psychiatric disorders in youth with ASD (i.e., anxiety, depression, attention-deficit/hyperactivity disorder, and behavioral/conduct problems) and caregiver coping. Another multiple binary logistic regression was run to examine whether family resilience moderates the aforementioned relationships. ResultsYouth with ASD and co-occurring conduct problems or depression were significantly more likely to be cared for by adults who were not coping well. High family resilience was directly associated with lower odds of poor parental coping; nonetheless, co-occurring conduct problems and depression were still associated with worse coping of caregivers after accounting for family resilience. ConclusionsFindings indicate that co-occurring depression and conduct problems in ASD youth may overwhelm their caregivers’ coping resources. Results also suggest that interventions targeting family resilience may improve the coping of adults caring for children and adolescents with ASD.

Associations between Obesity and Adverse Childhood Experiences in the United States.

Background: Obesity leads to serious health consequences in children and is potentially associated with increased adverse childhood experiences (ACEs). Nationally representative studies examining associations between obesity and ACEs are lacking. Therefore, we aimed to determine the relationship between ACEs and childhood obesity. Methods: We performed a retrospective cross-sectional study of children 10-17 years of age, who participated in the 2018 National Survey of Children's Health (NSCH), a national population-based survey. Obesity was determined by CDC definitions using BMI calculated by the NSCH from self-reported height/weight. Logistic regression, adjusted for key sociodemographic factors, determined differences in rates of ACEs between children with obesity (BMI ≥95th percentile) and those without (BMI <95th percentile). Results: Weighted NSCH data included 29,696,808 children 10-17 years of age, 15% with obesity. Obesity was associated with having more ACEs compared to other children (p < 0.01). In adjusted analyses, children with obesity were more likely than other children to report most ACEs, including food/housing insecurity [adjusted odds ratio (aOR) 1.64, confidence interval (95% CI) 1.26-2.13], parental divorce [1.67 (1.32-2.13)], witnessing physical violence [1.49 (1.03-2.16)], be a victim of violence [1.99, (1.27-3.12)], or live with a person with drug/alcohol abuse [1.65, (1.24-2.2)]. Children with obesity were also more likely to report ≥4 ACEs compared to other children (p < 0.001). Conclusion: Children with obesity are more likely to report ACEs overall and have more ACEs compared to other children. Obesity negatively affects child health; in combination with ACEs, health outcomes of children may be disproportionately affected, highlighting the importance of preventive screening and social interventions in childhood.

The Relationship Between Physical Activity and School Success Among Children With and Without Special Health Care Needs.

School-environments are thought to be strong influences of behavioral choices. There is limited research available on the role of physical activity (PA) and school success among children with special health care needs (CSHCN). The purpose of this study was to explore differences in PA among CSHCN and non-CSHCN and how the school success index is related to PA in both groups. Data were taken from new version of the National Survey of Children's Health (NSCH), which consolidated questions from the previous NSCH and the National Survey of Children with Special Health Care Needs (NS-CSHCN). Chi-square and logistic regression analyses were employed to examine group differences. There were significant differences among both subgroups, although most school-aged children did not meet recommended PA guidelines. Chi-squared analyses indicated; school engagement and the parent's perception of child safety at school were associated with the likelihood of meeting PA guidelines. Logistic regression analyses showed that the odds of meeting PA guidelines were associated with the school success index. Comprehensive school health programs should focus on PA both subgroups. School health educators should continue to advocate for safe and structured extracurricular activities to improve the child and adolescent's engagement and overall well-being.

Examining the Relationship Between Adverse Childhood Experiences and ADHD Diagnosis and Severity.

Although prior research has examined the prevalence of ACEs among children with attention deficit-hyperactivity disorder (ADHD), little is known about the household and family settings of children with ADHD. Our study utilizes a recent nationally representative dataset to examine the association between adverse childhood experiences (ACEs), child and household characteristics, and ADHD diagnosis and severity. Using the 2017-2018 National Survey of Children's Health (NSCH), our sample consisted of children three years of age or older, as this is the youngest age at which the NSCH begins to ask caregivers if a child has been diagnosed with ADHD (n=42,068). Multivariable logistic regression was used to examine the association between ACE type, score, and ADHD and ADHD severity, controlling for child and household characteristics. Children exposed to four or more ACEs had higher odds of ADHD (aOR 2.16; 95% CI 1.72-2.71) and moderate to severe ADHD (aOR 1.89; 95% CI 1.31-2.72) than children exposed to fewer than four ACEs. Other child characteristics positively associated with ADHD included age and public insurance; other Non-Hispanic races compared to Non-Hispanic White had lower odds of ADHD. Of children reported with ADHD, public insurance was also associated with caregiver-reported moderate to severe ADHD. Children with ADHD have a higher prevalence of ACEs, making this study important for understanding the relationship between ACEs and ADHD at the population level.

Adverse Childhood Experiences, Neighborhood Support, and Internalizing and Externalizing Mental Disorders among 6-17years old US Children: Evidence from a Population-Based Study.

We pooled data from four years (2016-2019) of the National Survey of Children's Health (NSCH) and included a nationally representative sample of 6 to 17years old US children (N = 94,369; Mean age = 11.53years, Standard Deviation [SD] = 3.53). Among 6-17-year-old US children, about 48% had a lifelong exposure to at least one of nine Adverse Childhood Experiences (ACEs), and 18.7% had a current diagnosis of at least one of four mental disorders. We examined the association between ACEs, neighborhood support, and mental disorders using several logistic regression models. More types of lifelong ACEs and lower neighborhood support were associated with a higher diagnosis of internalizing (anxiety/depression) and externalizing (ADHD/behavior problems) mental disorders (odds ratio [OR] > 1, and p < .001 for all relationships). After controlling for neighborhood support in the models, the odds ratios for ACEs attenuated but remained significant in all models regardless of mental disorder type or age group. However, the odds ratios for neighborhood support were larger for the association with ADHD/behavior problems than anxiety/depression. Moreover, odds ratios for neighborhood support levels were higher for older children (12-17years old) compared to younger (6-11years old) children. Higher neighborhood support appears to mitigate the adverse effects of ACEs on mental disorders, especially externalizing mental disorders (anxiety/depression) among adolescents (12-17years old).

Racial/ethnic differences in positive childhood experiences across a national sample

BackgroundExamination of racial/ethnic differences in positive childhood experiences (PCEs) is needed, as the absence of supportive factors may hinder children from healthy processing and mitigation of adversity. ObjectiveThe purpose of this study was to examine the prevalence of PCEs in a nationally representative sample of children and determine whether PCE exposure differed across race and ethnic groups. Participants and SettingData were drawn from the nationally representative 2017–2018 National Survey of Children’s Health (NSCH) (n = 33,747). MethodsDescriptive statistics and bivariate analyses were used in order to calculate frequencies, proportions, and unadjusted associations for each variable. Multivariable regression models were used to examine the association between race/ethnicity and PCEs. ResultsAll racial-ethnic minority groups of children had a lower likelihood of mentorship, living in a safe neighborhood, or living in a supportive neighborhood, than their Non-Hispanic White counterparts. Non-Hispanic Black children had a lower likelihood of having a mentor for advice or guidance (aOR 0.50; 95 % CI 0.38−0.62), living in a safe neighborhood (aOR 0.62; 95 % CI 0.52−0.73), and living in a supportive neighborhood (aOR 0.75; 95 % CI 0.64−0.87) than Non-Hispanic white children. ConclusionsThe information from this study highlights the negative disparities borne by racial/ethnic minority populations. Findings can be used to inform policymakers, program developers, and stakeholders on where to target interventions and how to bring together families and communities to not only confront adversity in childhood, but also to leverage community and family-level assets to create PCEs for all children.

Identifying Children With Medical Complexity From the National Survey of Children's Health Combined 2016-17 Data Set.

To develop a method of identifying children with medical complexity (CMC) from the National Survey of Children's Health (NSCH) 2016-2017 combined data set, to compare this approach to existing CMC identification strategies, and to describe sociodemographic characteristics of our CMC sample. Using survey items pertinent to the medical complexity domains in the style by Cohen et al (chronic health conditions, health service needs, health care use, and functional limitations), we created a schema to categorize children as CMC by applying a 95th percentile cutoff for survey item positivity. We applied existing CMC identification techniques to the NSCH. We used 2-proportion z tests to compare the classification output of our CMC identification method to those of existing approaches. We used χ2 analyses to examine relationships between child and family characteristics, comparing CMC with children with special health care needs (CSHCN) and children with no special health care needs. Among the 71 811 children in the sample, 1.5% were classified as CMC by our method, representing almost 1.2 million children (weighted) in the United States in 2016-2017. CSHCN and children with no special health care needs represented 17.2% (weighted n = 12.6 million) and 81.2% (weighted n = 59.6 million) of the sample, respectively. Our approach classified a significantly smaller number of CSHCN as CMC than existing CMC identification methods, which classified 3.9% to 13.2% of the 2016-2017 NSCH sample as more complex (P < .001). CMC status was significantly associated with male sex, minority race or ethnicity, and experiencing socioeconomic adversity (all P < .001). This method enables standardized identification of CMC from NSCH data sets, thus allowing for an examination of CMC health outcomes, pertinent to pediatric hospitalist medicine, contained in the survey.

The oral health status of America's rural children: An opportunity for policy change.

The purpose of our study was to examine the association between rurality and select oral health care metrics: teeth condition, decay, and access measures such as preventive dental care among children in the United States. We conducted a cross-sectional study with a sample of 20,842 respondents from the 2017 to 2018 National Survey of Children's Health (NSCH), a nationally representative sample of U.S. children. Socio-demographic information, residence, and oral health and healthcare utilization information were used to create study variables. Descriptive statistics, bivariate analyses, and a multivariable regression model were performed. Rural children were less likely to have a preventive dental visit than urban children (84.9percent versus 87.5percent, P=0.03). Children residing in rural areas were more likely to have their teeth condition reported as fair or poor than children residing in urban areas (7.3percent versus 6.6percent, P=0.02). Compared to their urban counterparts, rural children were also less likely to have received fluoride treatment (46.6percent versus 52.5percent, P=0.0022) and less likely to have received a dental sealant (19.5percent versus 22.5percent, P=0.0147). In adjusted analysis, there was no significant difference in receiving a preventive dental visit for rural children, compared to their urban counterparts. As preparations are made for the 2020 Surgeon General's report on oral health, the current study provides important evidence to inform future advocacy and legislative priorities. To reduce urban-rural disparities among children, there must be enhanced dental care access, dental workforce expansion, and increased awareness about preventive oral health services.

Association of Pediatric Hearing Loss and Head Injury in a Population‐Based Study

Traumatic brain injury (TBI) is the leading cause of acquired long‐term disability during childhood, and it may result in wide range of negative developmental consequences. Auditory dysfunction is generally recognized to be a possible sequela of pediatric TBI. Unfortunately, few contemporary studies have quantified the association between head injury and hearing loss in the pediatric population. The National Survey of Children’s Health (NSCH) for the combined years 2017‐2018 was used to determine the association of hearing loss with TBI. Deafness or problems with hearing were more commonly reported in children with a history or current brain injury/concussion compared to those without any such history (3.2% [70,000] and 1.2% [830,000] children, respectively; odds ratio, 2.67; P &lt;. 001). Findings suggest a notable association between TBI and hearing loss. Children with a history of TBI are 2.67 times more likely to have concurrent hearing complaints.Level of Evidence: IV

Do Caregivers’ Health Conditions Impact Children’s Externalizing Behavior? The Roles of Caregivers’ Parenting Frustration and Family Cohesion

The present study aimed to explore whether caregivers’ parental frustration mediates the relationship between parental health and children’s externalizing behaviors and whether family cohesion potentially moderates this association. Data were derived from the 2016 National Survey of Children’s Health (NSCH), and the total sample for the study included 50,212 adults. We tested the association between caregivers’ parental health and children’s externalizing behavior and whether parental frustration mediated the association between caregivers’ parental health and children’s externalizing behaviors. We performed a Sobel test to determine if the mediation was significant. To test the moderator, we conducted hierarchical multiple regression analyses to explore the interaction effect between caregivers’ parental health and family cohesiveness on children’s externalizing problems. We found a positive association between poor health conditions of caregivers and children’s externalizing behavior. Our findings also showed that parental frustration mediated the association between caregivers’ health conditions and children’s externalizing behavior. And finally, family cohesion was found to moderate the association between caregivers’ health conditions and children’s externalizing behavior. Our findings suggest that to prevent or address children’s externalizing behaviors, it is necessary to improve parental health, increase family cohesion, and reduce parental frustration.

Adverse childhood experiences and mental health conditions among multiracial adolescents

ABSTRACT The relationships between adverse childhood experiences (ACEs) and mental health conditions have received much attention in the literature. A particularly well-documented type of ACE is household dysfunction. However, compared to monoracial youth, little is known about the relationship between this type of ACE and mental health outcomes among multiracial adolescents. Objective The objective of this study was to verify the factor structure of the household dysfunction type of ACE using data from the National Survey of Children’s Health (NSCH), and then examine whether household dysfunction (measured as a latent construct) was associated with mental health conditions among multiracial adolescents. Design We used cross-sectional data collected in 2016 from caregivers who completed the NSCH and analyzed data from a subpopulation of adolescents (12–17) who reported more than one race (n = 1,231). Mplus 8.4 was used to conduct confirmatory factor analysis and probit models from a structural equation modeling framework. Results Results from this study indicated that the household dysfunction type of ACE, as a latent construct, had good model fit and was significantly associated with depression [standardized coefficient [B] = .50, 95% confidence interval [CI] .36, .65], anxiety [B = .61, 95% CI .48, .73], behavior problems [B = .58, 95% CI .44, .72], and ADHD [B = .54, 95% CI .38, .69] for multiracial adolescents. Conclusions Household dysfunction may result in adolescents being separated (physically or emotionally) from their caregivers, which may hinder adolescents’ ability to establish or maintain one of the most important relationships needed to promote racial/ethnic identity development and mental health. Implications for advancements in theory and NSCH are presented.

Adverse childhood experiences and traumatic brain injury among adolescents: findings from the 2016-2018 National Survey of Children's Health.

Exposure to adverse childhood experiences (ACEs) is a significant public health issue foryouth. However, traumatic brain injury (TBI) has been almost entirely overlooked in the ACEs and health outcomes literature, which has largely focused on the significant mental and behavioral health impact of ACEs. The goal the current study is to examine the association between ACEs and TBI among a nationally representative sample of adolescents in the United States and the extent to which ADHD and conduct problems inform this association. To assess this relationship, we use a sample of 42,204 adolescents (ages 12-17years) in the United States whose caregivers were surveyed during the three most recent cohorts (2016-2018) of the National Survey of Children's Health (NSCH). The results revealed a dose-response relationship between ACEs and TBI, even after accounting for an array of confounding variables. Findings also indicated that associations were of a greater magnitude among youth who are not sports-involved. Supplemental mediation analyses showed that ADHD and conduct problems attenuated associations between ACE exposure and TBI, but only in the absence of youth sports involvement. Given that both ACEs and TBI carry long-term consequences for health and well-being, the findings from this study draw attention to the need for early intervention and prevention programming (e.g. home visiting) that can reduce the prevalence of ACEs and a history of TBI among adolescents.

The impact of income level on childhood asthma in the USA: a secondary analysis study during 2011-2012

Despite the abundance of researches relating children and asthma, the racial/ethnic influence on asthma threat have not been fully explained. The aim was to conduct a consistent and new study on a large-scale nationally representative data, including a minority group that has been usually eliminated from racial/ethnic literature. The 2011-2012 National Survey of Children Health (NSCH) dataset was utilised. Asthma was more prevalent among African-American children (22.9%) more than white American children 13.1% (p ≤ .0001). Analysis of the multivariate model revealed a greater risk of asthma for the black African American children comparatively to white American children (adjusted OR 0.522, 95% CI 0.459-0.595). Our findings indicated that childhood asthma was associated with racial/ethnic status, especially with children with low income level.

Free open access data sources for dermatology researchers

Free open access data sources are a valuable tool for dermatology researchers and may uncover crucial information about dermatological diseases and delivery of dermatological care. This short review discusses six open access data sources including: National Health and Nutrition Examination Survey (NHANES), National Health Interview Survey (NHIS), National Survey of Children's Health (NSCH), National Ambulatory Medical Care Survey (NAMCS)/National Hospital Ambulatory Medical Care Survey (NHAMCS), Centers for Medicare and Medicaid Services (CMS), and Gene Expression Omnibus (GEO). We explain the role of each data source in dermatology and provide examples of past studies, which have used these data repositories.