Health risk behaviors, violence exposure, and current asthma among adolescents in the United States

Abstract

Background Asthma may worsen during adolescence, due to both health risk behaviors and psychosocial stressors commonly encountered during this life stage. Methods Cross‐sectional study of 24 612 high school students who participated in the 2009 and 2011 National Youth Risk Behavior Survey. Multivariable logistic regression was used to examine the relation between self‐reported health risk behaviors or psychosocial stressors and current asthma. Mediation analysis was performed to assess whether depressive symptoms or suicidal behavior contribute to the link between psychosocial stressors and asthma. Results Current asthma was reported by 13.1% of the study participants. In a multivariable analysis, female sex, obesity, shorter sleep duration, frequent soda/pop consumption, and marijuana use were each significantly associated with 14‐36% increased odds of asthma. Any violent behavior (adjusted odds ratio [OR] = 1.12, 95% confidence interval [CI] = 1.02‐1.24), any victimization (OR = 1.43, 95%CI = 1.29–1.58), any suicidal behavior (OR = 1.41, 95%CI = 1.22‐1.64) and having felt sad or hopeless in the past year (OR = 1.57, 95%CI = 1.40‐1.75) were each associated with current asthma. In a mediation analyses, having felt sad/hopeless and suicidal behaviors accounted for 21% and 14%, respectively, of the victimization‐asthma association. Conclusion Potentially modifiable risk factors, including obesity, short sleep duration, frequent soda/pop consumption, and psychosocial stressors are associated with asthma in US adolescents. Promoting healthier lifestyles, as well as screening for violence exposure and treating depressive symptoms, could help reduce asthma burden in this population.

Structural and Social Determinants of Health in Asthma in Developed Economies: a Scoping Review of Literature Published Between 2014 and 2019

“…Special Considerations: Sugar-Sweetened Beverages Sugarsweetened beverages (SSBs) are a nutritional component that has received increasing attention over the last decade. SSBs are associated with asthma prevalence and morbidity, independent of obesity, in children and adults in cross-sectional and prospective studies [101][102][103][104][105][106][107][108]. In the prospective Framingham Offspring Cohort study, the consumption of SSBs with excess fructose content was associated with a dose-dependent increase in asthma risk for adults (HR, 1.89; 95%CI 1.36-2.62 for 5-7 servings/week) when adjusted for demographics, BMI, smoking, and type II diabetes [102••].…”

“…Similar to other stressors, the effect of community violence on asthma outcomes likely manifests through the same dysregulation of the biological response to stress [127] and through indirect mechanisms (e.g., parental smoking, depression, medication adherence, or time indoors due to safety concerns) [128]. Multiple studies have built upon earlier work demonstrating an association between asthma and community violence across the age spectrum [108,[128][129][130][131]. Census tract level violent crime in Cincinnati was associated with increased ED utilization rates for children with asthma after adjusting for tract level rates of poverty, unemployment, substandard housing, and traffic exposure [132•].…”

Association between soft drinks consumption and asthma: a systematic review and meta-analysis

“…Table 1 shows the main characteristics of all 19 studies included in our review. Twelve studies reported on childhood exposure to soft drinks,5 11 12 14 24–31 six studies on adulthood exposure to soft drinks13 15 16 32–34 and two studies on maternal consumption of soft drinks and asthma in the offspring 31 35. Three studies were cohort studies16 31 35 and 16 were cross-sectional studies 5 12–15 24 26–30 32–34 36 37.…”

“…Twelve studies reported on childhood exposure to soft drinks,5 11 12 14 24–31 six studies on adulthood exposure to soft drinks13 15 16 32–34 and two studies on maternal consumption of soft drinks and asthma in the offspring 31 35. Three studies were cohort studies16 31 35 and 16 were cross-sectional studies 5 12–15 24 26–30 32–34 36 37. Six studies were conducted in Europe,5 14 26 29 32 35 six in the USA,12 16 24 31 33 36 four in Asia,15 25 27 34 one in Brazil,30 one in New Zealand28 and one in Australia 13.…”

Association of Sleep Duration and Weekend Catch-Up Sleep with Suicidal Ideation Among Adolescents with Asthma: Secondary Data Analysis Based on a Nationwide Cross-Sectional Study

“…The negative in uence of asthma on mental-health states is widely accepted; people with asthma had a signi cantly increased risk of depression than did controls [23,27]. Adolescents with asthma may potentially experience more psychological burden from the disease than do adult patients [23,35,36].…”