Intimate Partner Violence and Adult Asthma Morbidity: A Population-Based Study

Eileen Wang; Bryan Simmons; Kristen E Holm; Rafeul Alam; Frederick S Wamboldt

doi:10.1016/j.jaip.2021.06.023

Intimate Partner Violence and Adult Asthma Morbidity: A Population-Based Study

J Allergy Clin Immunol Pract. 2021 Dec;9(12):4300-4309.e7. doi: 10.1016/j.jaip.2021.06.023. Epub 2021 Aug 4.

Authors

Eileen Wang¹, Bryan Simmons², Kristen E Holm³, Rafeul Alam⁴, Frederick S Wamboldt⁵

Affiliations

¹ Division of Allergy and Immunology, Department of Medicine, National Jewish Health, Denver, Colo; Division of Allergy and Immunology, Department of Medicine, University of Colorado School of Medicine, Aurora, Colo. Electronic address: wange@njhealth.org.
² Center for Health Promotion, Division of Sleep Medicine, Department of Medicine, National Jewish Health, Denver, Colo.
³ Division of Allergy and Immunology, Department of Medicine, National Jewish Health, Denver, Colo; Division of Neurology, Department of Medicine, National Jewish Health, Denver, Colo; Department of Community and Behavioral Health, University of Colorado School of Public Health, Aurora, Colo.
⁴ Division of Allergy and Immunology, Department of Medicine, National Jewish Health, Denver, Colo; Division of Allergy and Immunology, Department of Medicine, University of Colorado School of Medicine, Aurora, Colo.
⁵ Division of Medical, Behavioral and Community Health, Department of Medicine, National Jewish Health, Denver, Colo.

PMID: 34364825
DOI: 10.1016/j.jaip.2021.06.023

Abstract

Background: The etiologies for difficult-to-control asthma are complex and incompletely understood. Intimate partner violence (IPV) is a pervasive problem and may play a role in difficult-to-control asthma. IPV is associated with increased prevalence of asthma. There are no prior studies evaluating IPV's association with adult asthma exacerbations.

Objective: This study hypothesized that IPV exposure would be associated with increased asthma exacerbations, higher symptom burden, and poorer asthma control among adults.

Methods: Analyses are based on 2634 adults who participated in the 2005 Behavioral Risk Factor Surveillance System survey, reported active asthma, and completed the asthma and IPV questions. We used multivariate logistic regression to examine the association of IPV with asthma morbidity outcomes while controlling for the following potential confounders: sex, race, education, health care coverage, smoking status, age, and body mass index.

Results: The prevalence of IPV was 32.4%. IPV was associated with increased odds of an asthma exacerbation (adjusted odds ratio [AOR] = 1.75, 95% confidence interval [CI] = 1.26-2.43), higher symptom burden (AOR = 2.33, 95% CI = 1.53-3.55), and lack of asthma control (AOR = 2.23, 95% CI = 1.22-4.09) when using composite measures for these outcomes. When using single-item measures for outcomes, IPV was also associated with increased asthma-related emergency department or urgent care visits (AOR = 2.35, 95% CI = 1.56-3.54), other urgent provider visits (AOR = 1.84, 95% CI = 1.28-2.64), perceived asthma attacks (AOR = 1.53, 95% CI = 1.12-2.09), limitations (AOR = 2.07, 95% CI = 1.49-2.89), daytime symptoms (AOR = 1.92, 95% CI = 1.35-2.72), and nocturnal awakenings (AOR = 1.88, 95% CI = 1.32-2.69).

Conclusions: IPV is prevalent in adult asthmatics and consistently and significantly associated with worsened adult asthma morbidity, even after adjusting for key confounders. Further research is needed to more fully understand the mechanisms underlying these relationships.

Keywords: Asthma; Control; Exacerbations; Intimate partner violence; Morbidity; Outcomes.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Adult
Asthma* / epidemiology
Cross-Sectional Studies
Humans
Intimate Partner Violence*
Odds Ratio
Prevalence
Risk Factors