Stressful Life Events and Asthma Control: Detecting Children at Risk for Adverse Asthma Outcomes

Abstract

Given the persistence of pediatric asthma disparities and the established link between stress and poor asthma control, it remains important to identify children who might be at risk for experiencing adverse asthma outcomes. This study examined the degree of exposure to stressful life events (SLEs; e.g., financial problems, family illness, unsafe neighborhoods) in a sample of children with asthma. In a community asthma program, RVA Breathes, 235 children (mean ± SD child age = 7.07 ± 1.65 years, 78.3% African American/Black, 55.3% household income <$25,000/year) and their caregivers completed baseline measures, including the Childhood Asthma Control Test (cACT) and the SLEs Checklist (SLECC). After controlling for factors such as child age, race, ethnicity, controller medication use, and family income, SLEs (experienced within the prior 6 months) accounted for significant variance in asthma control scores, F(6, 172) = 2.71, p = .015, R ² = .086. The odds of poor asthma control (i.e., cACT ≤19) increased by approximately 14% for each additional SLE. Based on the observed probabilities, a child who experienced five SLEs within the last 6 months had a 50% chance of having uncontrolled asthma. Clinically, these findings highlight the importance of assessing exposure to stressful life events, as it could aid in the early identification of children at risk for poor asthma control. In response, clinicians could provide targeted resources and interventions to families that address social and environmental factors associated with adverse asthma outcomes.

Implications for Impact Statement

The present study highlights a connection between experiencing more stressful life events and poor asthma control in children. For instance, experiencing five stressful life events was associated with approximately a 50% chance of having uncontrolled asthma. Identifying children experiencing multiple stressors may help clinicians connect families with targeted resources or interventions to reduce stress, with the overall goal of improving asthma management in pediatric populations.