Examining Social Determinants of Health in Childhood Asthma Management.
Sharon D Horner
PMID 32796383WHAT IT FOUND
In 292 children with asthma, family social and economic status, race/ethnicity and home language were linked to asthma management, inhaler skill, emergency visits and quality of life, but the pattern was mixed.
Key findings
01Family socioeconomic status was linked to parents' asthma management, emergency visits, and parents' and children's total and emotional quality of life, but not to children's asthma self-management, inhaler skill, symptom quality of life, or activity limitations.
02Children in Spanish-speaking families had lower inhaler skill and less asthma self-management, while Spanish-speaking parents reported more asthma management than English-speaking parents.
03Children who attended minority-serving schools had lower family socioeconomic status, more emergency visits, lower inhaler skill and poorer total quality of life than children who attended majority-serving schools, while asthma severity, child self-management and hospital stays did not differ.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was a convenience sample from one region and 33 rural-adjacent elementary schools, so it may not represent other communities. The study was cross-sectional, so it found associations at one time and cannot show that social factors caused asthma management, emergency visits or quality of life differences. Emergency visits and hospitalizations were parent-reported for the past year and could not be confirmed because families traveled to urban centers for care. Race and ethnicity and socioeconomic status were confounded because Hispanic families had the lowest socioeconomic status, followed by African American families, then non-Hispanic white families. School majority or minority status was used as a proxy for neighborhood, not a direct measure of community conditions. No asthma education intervention was tested, so the study does not show that any program improved outcomes.
Declared interests
The author reported no conflicts of interest.
The easy way to misread this
Do not treat lower family income or minority school attendance as causes of worse asthma outcomes. This cross-sectional survey only found associations and tested no intervention.