title: Parents' childhood socioeconomic circumstances are associated with their children's asthma outcomes.
abstract: BACKGROUND
  Previous literature documents associations between low socioeconomic status (SES) and poor health outcomes, including asthma. However, this literature has largely focused on the effects of current family circumstances.
  
  
  OBJECTIVE
  We sought to test an intergenerational hypothesis, that the childhood SES that parents experience will be associated with asthma outcomes in their children, independent of effects of current family SES. Second, we aimed to test whether this association is in part due to difficulties in current parent-child relationships.
  
  
  METHODS
  This was an observational study, whereby 150 parents were interviewed about their childhood SES and their children (physician-diagnosed asthma, ages 9-17 years) were interviewed about current family stress. Asthma control was assessed by parent report and child report (primary outcome), and blood was collected from children to measure cytokine production relevant to asthma (secondary outcomes).
  
  
  RESULTS
  To the degree that parents had lower childhood SES, their offspring showed worse asthma outcomes across multiple indicators. This included lower asthma control scores (parent and child report, Ps < .05), and greater stimulated production of TH2 and TH1 cytokines by PBMCs (Ps < .05). These associations were independent of current family SES. Mediation analyses were consistent with a scenario wherein parents with low childhood SES had current family relationships that were more stressful, and these difficulties, in turn, related to worse asthma control and greater cytokine production in children.
  
  
  CONCLUSIONS
  These results suggest the potential "long reach" of low SES across generations, and the importance of expanding theories of how the social environment can affect childhood asthma to include characteristics of earlier generations.
authors.affiliation: Department of Psychology, Institute for Policy Research, Northwestern University, Evanston, Ill. Electronic address: edith.chen@northwestern.edu.
authors.forename: Edith
authors.initials: E
authors.lastname: Chen
authors.affiliation: NorthShore University Health Systems, Evanston, Ill.
authors.forename: Madeleine U
authors.initials: MU
authors.lastname: Shalowitz
authors.affiliation: NorthShore University Health Systems, Evanston, Ill.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Story
authors.affiliation: Department of Psychology, Institute for Policy Research, Northwestern University, Evanston, Ill.
authors.forename: Katherine B
authors.initials: KB
authors.lastname: Ehrlich
authors.affiliation: Department of Psychology, Institute for Policy Research, Northwestern University, Evanston, Ill.
authors.forename: Erika M
authors.initials: EM
authors.lastname: Manczak
authors.affiliation: Department of Psychology, Institute for Policy Research, Northwestern University, Evanston, Ill.
authors.forename: Paula J
authors.initials: PJ
authors.lastname: Ham
authors.affiliation: Department of Psychology, Institute for Policy Research, Northwestern University, Evanston, Ill.
authors.forename: Van
authors.initials: V
authors.lastname: Le
authors.affiliation: Department of Psychology, Institute for Policy Research, Northwestern University, Evanston, Ill.
authors.forename: Gregory E
authors.initials: GE
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000097:blood / Q000453:epidemiology / Q000276:immunology / Q000523:psychology*; D002648:Child; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000276:immunology; D008297:Male; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D012931:Social Environment; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000097:blood / Q000453:epidemiology / Q000276:immunology; D011795:Surveys and Questionnaires
chemical_list: D016207:Cytokines
keywords: Socioeconomic status; asthma; childhood; family stress