Asthma is associated with bullying victimization in rural adolescents

Abstract

Objective

We characterized bullying among rural adolescents and examined the association between asthma and bullying victimization.

Methods

Participants (N = 1905; 44.5% Black) were students attending rural high schools who were screened for a randomized trial to address uncontrolled asthma. Screening questions asked students about asthma diagnosis and symptoms, bullying victimization, and demographic characteristics. Logistic regression analyses with school as a fixed effect were employed to examine the extent to which demographic factors, asthma diagnosis, asthma status (i.e. current asthma, no asthma, possible undiagnosed asthma), and among those with current asthma, asthma severity, were associated with bullying victimization. Sensitivity analyses using bullying frequency as the outcome were also conducted.

Results

26.0% reported being bullied. Younger age and self-identifying as White were associated with increased risk of bullying victimization. Compared to those with no asthma, those with current asthma or possible undiagnosed asthma were at increased risk for bullying victimization (adjusted odds ratio [AOR] = 2.46; 95% confidence interval (CI) = 1.76–3.46 and AOR = 2.42; 95% CI = 1.87–3.14, respectively). Among those with current asthma, persistent symptoms increased the risk for bullying victimization (AOR = 2.59; 95% CI = 1.45–4.71). Similar results were obtained with sensitivity analyses.

Conclusions

In a large rural community cohort, asthma was associated with bullying victimization. Findings suggest that rural students with asthma, with or without diagnosis, could benefit from schools creating inclusive environments that reduce victimization based on this medical condition. School administrators should foster environments that are accepting of all students’ abilities and statuses, and healthcare providers can provide proper asthma management education to these adolescents.

Keywords:

• Asthma
• bullying
• chronic condition
• non-urban
• victimization
• youth

Declaration of interest

The authors have no conflicts of interest to declare.

Funding

Data collection and manuscript preparation were supported by the National Heart, Lung, And Blood Institute of the National Institutes of Health (R01HL136753) awarded to Jean-Marie Bruzzese. Ms. Ancheta’s effort on this study was supported in part by an Individual Predoctoral Fellowship funded by the National Institute of Nursing Research (F31NR019432). The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.