Asthma in urban Aboriginal children: A cross‐sectional study of socio‐demographic patterns and associations with pre‐natal and current carer smoking

Abstract

Aim To describe socio‐demographic patterns of asthma prevalence in urban Aboriginal children and quantify associations between asthma prevalence and pre‐natal maternal and current carer smoking. Methods Analyses used carer‐reported survey data for 1290 urban Aboriginal children aged 2–17 years from the Study of Environment on Aboriginal Resilience and Child Health. Multilevel log‐binomial regression was used to estimate asthma prevalence ratios (PRs) for child‐ and family‐level socio‐demographic factors, pre‐natal maternal smoking and current carer smoking. Smoking‐related PRs were compared with general‐population estimates derived from meta‐analyses of published cross‐sectional data. Results Overall, 33.9% of children had ever had asthma, and 12.9% had received treatment for asthma in the past month. Prevalence estimates declined with increasing household income and increasing household size (posterior probabilities of decreasing trend >0.98), while children exposed to pre‐natal maternal smoking had a higher risk of asthma ever than unexposed children (PR 1.18 (95% credible interval 1.00–1.40)). Recently treated asthma prevalence was not significantly associated with pre‐natal maternal (0.98 (0.71–1.41)) or current carer smoking (0.97 (0.68–1.37)); however, there was substantial uncertainty in our PR estimates, and 95% credible intervals contained general‐population estimates derived from the meta‐analyses (1.37 (1.17–1.65) for pre‐natal smoking, 1.28 (1.15–1.44) for current parental or household smoking). Conclusion Among urban Aboriginal children in the Study of Environment on Aboriginal Resilience and Child Health cohort, asthma prevalence declines as household income and household size increase, while children exposed to pre‐natal maternal smoking are at increased risk of ever having asthma. Our results emphasise the importance of reducing smoking in Aboriginal communities, particularly among pregnant women.

Social deprivation and spatial clustering of childhood asthma in Australia

“…Asthma prevalence is higher among Indigenous communities in Australia [ 38 ], and previous research has reported that asthma is a significant cause of morbidity and the most prevalent chronic respiratory condition among Indigenous populations, supporting this finding [ 39 , 40 ]. Various factors can contribute to the high asthma prevalence, including smoking, limited access to culturally appropriate health services, and social-environmental factors [ 40 , 41 ]. For example, low income can lead to poor living conditions and exposure to environmental asthma triggers such as household moulding or air pollution, as well as limited access to healthcare resources and medications, resulting in poor asthma control and a high prevalence.…”

“…This study found that areas with a high proportion of Indigenous people had a higher childhood asthma prevalence. Asthma prevalence is higher among Indigenous communities in Australia [38], and previous research has reported that asthma is a significant cause of morbidity and the most prevalent chronic respiratory condition among Indigenous populations, supporting this finding [39,40]. Various factors can contribute to the high asthma prevalence, including smoking, limited access to culturally appropriate health services, and socialenvironmental factors [40,41].…”

“…For example, low income can lead to poor living conditions and exposure to environmental asthma triggers such as household moulding or air pollution, as well as limited access to healthcare resources and medications, resulting in poor asthma control and a high prevalence. According to a Western Australian study, the prevalence of asthma in Aboriginal children rises with decreasing household income [ 40 ]. Moreover, the marginalisation of Indigenous populations in disadvantaged neighbourhoods can be attributed to broader, ongoing political, economic, and social determinants of health due to the ongoing impacts of colonisation.…”

Prevalence and risk factors for self-reported asthma among sámi in Sweden: a cross-sectional study

“…However, it may also be the case that the reindeer-herding-related questions failed to separate out the small group of active reindeer herders, who are more exposed to risk factors such as cold climate exposure. Other risk factors, found for example in Canadian aboriginals, like smoking, urban residence, low education and low household income (7,19,20), were not relevant for this Sámi population.…”