Online Program

Assessing the Relationship between Depressive Symptoms and Poorly-Controlled Asthma among Florida Adolescents

Tuesday, November 3, 2015

Megan MacDonald, MPH, Bureau of Chronic Disease Prevention, Florida Department of Health, Tallahassee, FL
Brittny Wells, DrPH, CHES, Behavior Sciences and Social Medicine, Florida State University, Tallahassee, FL
Cheryl Clark, DrPH, Division of Children's Medical Services, Florida Department of Health, Tallahassee, FL

Asthma is a chronic respiratory disease that causes breathing problems and can be life threatening without proper management. In Florida, approximately 11% of adolescents have asthma, and some research shows that depressive disorders are more prevalent in asthmatic individuals.  The purpose of the present analysis was to investigate the association between adverse asthma outcomes and symptoms of depression among Florida middle and high school students.


A cross-sectional analysis was conducted using data from the 2014 Florida Youth Tobacco Survey, a statewide, school-based survey of public middle and high school students. The study population was limited to students ages 11 to 18 with current asthma. Data were analyzed using SAS 9.4.  Logistic regression analyses were performed to evaluate the relationship between adverse asthma outcomes, which included having an asthma attack or an emergency medical care visit (EMC), including visits to an emergency department or urgent care center, and self-reported symptoms of depression.


The study sample included 7,146 respondents ages 11 to 18 who reported currently having asthma, and 34% of these students reported having depressive symptoms (feeling sad or hopeless) in the past year.  Students were significantly more likely to experience depressive symptoms if they had an asthma attack (OR: 1.47), one to three EMC visits (OR: 1.33) or more than ten EMC visits (OR: 2.72).


This study found that adolescents with poorly-controlled asthma have an elevated risk of experiencing depressive symptoms.  A limitation of the study was that it could not be determined whether depressive symptoms preceded or followed the asthma-related events, due to the cross-sectional design of the survey. The results of this analysis warrant further exploration of the implications of depressive disorders among asthmatic youth in order to identify appropriate intervention and health promotion opportunities for this population.

Learning Areas:

Chronic disease management and prevention
Planning of health education strategies, interventions, and programs
Public health or related education
Social and behavioral sciences

Learning Objectives:
Analyze symptoms of depression among middle and high school-aged children in Florida. Identify gender differences among asthmatic middle and high school-aged children in Florida who report symptoms of depression. Investigate the impact of emergency room visits among asthmatic middle and high school-aged children in Florida who report symptoms of depression. Discuss the connection between asthma, psychological dysfunction, and academic achievement among school aged children. Provide recommendations for future implications of data analysis and research.

Keyword(s): Depression, Asthma

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have extensive experience planning, implementing, and evaluating programs to reduce the burden of chronic disease and improve health disparities among those with chronic health conditions.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.