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

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
• race/ethnicity
• health disparities
• social determinants of health
• child and adolescent health

Acknowledgements

This paper is based on public data from the Child and Adolescent Health Measurement Initiative (CAHMI) by the Data Resource Center for Child and Adolescent Health (DRC). The views and opinions expressed in this paper are those of the authors and do not represent the views of CAHMI. Dr. Baiden had full access to all of the data, the research, and writing process and assumes responsibility for the integrity of the data, the accuracy of the data analysis, and take final responsibility for the paper.