The influence of caregiver's psychosocial status on childhood asthma and obesity.
BACKGROUND
The prevalence of childhood asthma and childhood overweight has increased in the last 2 decades, disproportionately burdening ethnic minority children and those living in poverty with no clear understanding of underlying mechanisms.


OBJECTIVE
To explore the influence of demographic variables, childhood obesity (adjusted body mass index > or = 95th percentile), caregivers' smoking status, and caregiver psychosocial status on asthma severity and asthma control in an urban sample of children with persistent asthma.


METHODS
Child (with asthma)-caregiver dyads were recruited from public and archdiocese schools in Chicago, Illinois, as part of the Chicago Initiative to Raise Asthma Health Equity. Data were collected as part of the baseline face-to-face surveys conducted within the community.


RESULTS
The 531 dyads were divided into 2 groups: 294 taking controller medications were in the asthma control analyses and 237 taking rescue medications only were in the asthma severity analyses. In multivariate models, asthma control was significantly worse in obese children (odds ratio [OR], 1.89; 95% confidence interval [CI], 1.17-3.05), African American children (OR, 2.16; 95% CI, 1.05-4.46), and those with caregivers who had higher stress (OR, 1.09; 95% CI, 1.01-1.18). Older children had better control (OR, 0.79; 95% CI, 0.69-0.90). Children with caregivers who wanted more asthma-specific social support were more likely to have moderate to severe asthma (OR, 2.07; 95% CI, 1.06-4.05).


CONCLUSIONS
In this community-based sample of children with active asthma, asthma control and asthma severity were associated with different factors. Caregiver variables were significant in both outcomes, and childhood obesity was associated only with poor asthma control.
Sharp
Lisa K
LK
Department of Medicine, Section of Health Promotion Research, University of Illinois at Chicago, Chicago, Illinois 60608, USA. sharpl@uic.edu
Curtis
Laura M
LM
Mosnaim
Giselle
G
Shalowitz
Madeleine U
MU
Catrambone
Cathy
C
Sadowski
Laura S
LS
D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000453:epidemiology* / Q000517:prevention & control*; D015992:Body Mass Index; D017028:Caregivers / Q000523:psychology*; D002648:Child; D005260:Female; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D008297:Male; D009765:Obesity / Q000453:epidemiology*; D012307:Risk Factors; D014505:Urban Population
D018927:Anti-Asthmatic Agents