Caregiver Trauma and Childhood Asthma Control in Urban Families

The influence of caregiver post-traumatic stress disorder (PTSD) on asthma symptoms in high-risk children with asthma is unknown.

This study is part of the Rush Center for Urban Health Equity. Community outreach was used to recruit 64 families with children 5-12 years of age who were overweight/obese with asthma. Asthma symptoms were self-report; medications were assessed objectively. Caregivers reported the number of traumatic life events they had experienced and type of threat posed by events. The Short Form of the PTSD Checklist - Civilian Version assessed PTSD symptoms. Caregiver depression was measured using the Patient Health Questionnaire–9.

Participants were mainly Puerto Rican (41%), Mexican (34%), or African American (20%). 83% reported household annual incomes of less than $30,000. 70% of children had uncontrolled asthma over the past four weeks; 83% were uncontrolled over the past year. Caregivers endorsed high levels of psychological distress: 66% had experienced at least one traumatic life event, 39% experienced an event that threatened their body or life directly. 33% of caregivers screened positive for PTSD and 31% screened positive for depression. Caregiver PTSD scores were higher among those whose children exhibited excessive daytime asthma symptoms (p<.05). Exposure to threat was higher among parents with children with excessive daytime asthma symptoms (p<.01), activity interference (p<.05), overall poor asthma control (p<.05), and not having a spacer (p<0.05). Caregiver depression was associated only with activity interference (p<.05).

For low-income urban families, caregiver trauma history and PTSD may be critical risk factors for child asthma control and medication access.