Family support may improve asthma outcomes for children

Washington: Want to help your child cope with asthma? Better family relationships are associated with good asthma management behaviours and outcomes for those living in dangerous neighbourhoods, a new study reveals.

The findings of the study were published in the journal ‘Pediatrics’. For children with asthma, neighbourhood environmental conditions — the role of allergens and pollutants, for example — have long been known to play an important role, but less is known about how social conditions in the neighbourhood might affect children’s asthma.

In the study, researchers sought to test whether there are social factors that can buffer children from the negative effects of difficult neighbourhood conditions, focusing on one particular factor they thought would be important in the lives of children — whether they had positive and supportive family relationships.

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“We found significant interactions between neighbourhood conditions and family relationship quality predicting clinical asthma outcomes,” said lead study author Edith Chen.

“When children lived in neighbourhoods that were high in danger and disorder, the better their family relationships, the fewer symptoms and activity limitations they had, and the better their pulmonary,” Chen added.

In contrast, Chen said, when children lived in neighbourhoods that were lower in danger and disorder, their symptoms, activity limitations and pulmonary function were generally good, and the nature of their family relationships didn’t really matter.

Using Google Street View, the researchers were able to take a virtual walk through each of the research participant’s neighbourhoods, and code for indicators of neighbourhood danger or disorder, including evidence of graffiti, rundown or abandoned cars, bars or grates on windows and doors, and abandoned or boarded-up homes. That gave them a more objective indicator of the level of neighbourhood danger and disorder that a participant is likely experiencing on a daily basis as they walk to places from their home.

They then interviewed children about their family relationships and coded the amount of support, trust, and conflict that was present, and measured a variety of asthma outcomes — clinical, behavioural and biological — in these children.

Chen said the research is important to the field of paediatrics because families often don’t have options for moving out of neighbourhoods that are challenging.

“If paediatricians can provide suggestions to families about how supportive relationships can help with managing their child’s asthma, while at the same time still acknowledging the realities of the ongoing neighbourhood difficulties that many of these families face, this might help families,” Chen said.

It’s possible that when children have high-quality relationships with their family, family members are able to help their children prioritize asthma management, for example, perhaps by shielding them from neighbourhood stressors in order to minimize the disruption to asthma routines.

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