Adverse childhood experiences and risk factors associated with asthma among children in the United States: the intersection of sex and race/ethnicity

J Asthma. 2022 Jun;59(6):1122-1130. doi: 10.1080/02770903.2021.1910296. Epub 2021 Apr 14.

Abstract

Objective: The objectives of this cross-sectional study were to examine: 1) the association between adverse childhood experiences (ACEs) and asthma among children, and 2) the interaction between sex and race/ethnicity on asthma.

Methods: Data for this study were obtained from the 2017-2018 National Survey of Children's Health. Binary logistic regression was conducted on an analytic sample of 49,000 children ages 0-17 years with asthma as the outcome variable and ACEs as the main explanatory variable.

Results: Based on parent reports, we found that 11.5% of children had asthma and about 42% had at least one ACE, with 9.7% having ≥3 ACEs. Controlling for other factors, children with ≥3 ACEs had 1.45 times higher odds of having asthma when compared to children with no ACEs. Non-Hispanic Black males and females were more likely to have asthma when compared to non-Hispanic White males.

Conclusions: The findings of this study demonstrate an association between ACEs and asthma with children exposed to ≥3 ACEs more likely to have asthma underscoring the importance of cumulative effect of ACEs on asthma. Our study also revealed an interaction between sex and race/ethnicity on asthma among children. Additional studies are needed to understand the mechanisms through which ACEs is associated with asthma among children.

Keywords: Adverse childhood experiences; asthma; child and adolescent health; health disparities; race/ethnicity; social determinants of health.

MeSH terms

  • Adolescent
  • Adverse Childhood Experiences*
  • Asthma* / epidemiology
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Ethnicity
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Risk Factors
  • United States / epidemiology