Parents' childhood socioeconomic circumstances are associated with their children's asthma outcomes

Abstract

Background Previous literature documents associations between low socioeconomic status (SES) and poor health outcomes, including asthma. However, this literature has largely focused on the effects of current family circumstances. Objective To test an intergenerational hypothesis, that the childhood SES that parents experience will be associated with asthma outcomes in their children, independent of effects of current family SES. Secondly, to test whether this association is in part due to difficulties in current parent-child relationships. Methods Observational study, whereby 150 parents were interviewed about their childhood SES, and their children (physician-diagnosed with asthma, ages 9–17) were interviewed about current family stress. Asthma control was assessed by parent- and child-report (primary outcome), and blood was collected from children to measure cytokine production relevant to asthma (secondary outcomes). Results To the degree that parents had lower childhood SES, their offspring showed worse asthma outcomes across multiple indicators. This included lower asthma control scores (parent and child-report, p’s<.05), and greater stimulated production of Th-2 and Th-1 cytokines by peripheral blood mononuclear cells (PBMC) (p’s<.05). These associations were independent of current family SES. Mediation analyses were consistent with a scenario wherein parents with low childhood SES had current family relationships that were more stressful, and these difficulties in turn related to worse asthma control and greater cytokine production in children. Conclusions These results suggest the potential ‘long reach’ of low socioeconomic status across generations, and the importance of expanding theories of how the social environment can affect childhood asthma to include characteristics of earlier generations.

Mothers’ childhood hardship forecasts adverse pregnancy outcomes: Role of inflammatory, lifestyle, and psychosocial pathways

“…Mirroring evidence of cross-generational transmission of health disparities (Pembrey et al 2014; Schreier & Chen 2010; Chen et al 2016b), we observed a consistent relationship between mothers’ childhood hardship and adverse pregnancy outcomes. Women who experienced disadvantaged childhoods were more likely to deliver preterm, SGA babies.…”

“…In doing so, it draws attention to the incremental costs associated with this phenomenon, and begins to clarify some of the underlying behavioral and biological mechanisms. It also contributes to the growing literature on inter-generational effects (Pembrey et al 2014; Schreier & Chen 2010; Chen et al 2016b), and extends knowledge in this domain by highlighting pregnancy as a sensitive period during which health disparities may be transmitted across generations.…”

“…For example, to the degree parents were exposed to childhood economic hardship, their adolescent offspring showed more cardiovascular risk, as reflected in higher blood pressure and low-grade inflammation (Schreier & Chen 2010). In youth with asthma, parental economic hardship during childhood predicted worse disease control and larger cytokine responses to allergens (Chen et al 2016b). In both of these studies, the associations were independent of the family’s current socioeconomic conditions.…”

Divergent transcriptional profiles in pediatric asthma patients of low and high socioeconomic status

“…This cross-sectional analysis focuses on 99 children with asthma from either lower-SES (n = 49) or higher-SES (n = 50) families. They were drawn for a gene-expression sub-study from a larger cohort of 308 patients 19 and represent the poles of that sample's SES distribution.…”

Issues affecting reliable and valid assessment of early life stressors in psychosis

“…It is important to consider that previous studies suggest that regardless of whether the population suffers from psychopathology, retrospective report accuracy tends to improve with salience and contextual detail (Brewin et al, 1993). Principles from cognitive psychology could aid us in this case: for example, retrospective measures with good recall performance ask for "number of rooms in your household growing up" as a proxy for developmental SES (Chen et al, 2017). Further, building techniques such as anchoring into inventories is a viable technique (e.g., discussing events in the context of seasons/school years/life-events) (Brewin et al, 1993).…”