Is parental mental health associated with worse asthma morbidity in children with asthma than living with a parent who smokes?

The current study examined the impact of parental mental health and smoking status on asthma control of in children. Exposure to environmental tobacco smoke (ETS) and poor parental mental health has been linked to worse health outcomes in children with asthma, however, the impact of these factors have not been compared in a nationally representative sample. This opportunity exists with the Child Asthma Call-Back Survey linked to the Behavioral Risk Factor Surveillance System (BRFSS), which is administered to parents who report living in a home with a child with asthma. The study sample included 2,093 parents who completed the Child Asthma Call-Back Survey regarding one of their children. A majority of the sample of children were male (58.3%) and non-Hispanic White (56.4%). Parental mental health was a composite measure of three variables (social support, life satisfaction, and recent depression/anxiety). Poor asthma control was a composite measure consisting of four indicators (recent asthma exacerbation, moderate to a lot of activity limitations, recent asthma-related emergency department visit, and use of short-acting beta-2 agonists bronchodilators). A multivariate logistic regression model indicated that poor mental health (β=0.190; 95% Confidence Interval [CI]= 0.12-0.26) and smoking among parents (β=0.193; 95% CI= 0.05-0.33) contributed similarly to poor asthma control in children. Results also showed that non-Hispanic Black children had higher poorly controlled asthma scores (β=0.235; 95% CI= 0.15-0.32) compared to non-Hispanic Whites. These results indicate that both parental smoking behavior and comprehensive mental health assessment should be targets of interventions to improve children's asthma control.