Online Program

Caregiver Employment and Asthma Outcomes in Inner City Children with Persistent Asthma

Sunday, November 1, 2015

Joan Kub, PhD PHCNS, BC FAAN, Department of Community Public Health, Johns Hopkins School of Nursing, Baltimore, MD
Melissa Bellin, PhD, LCSW, Chair, Health Specialization, University of Maryland, Baltimore
Mary Elizabeth Bollinger, DO, Department of Pediatric Pulmonary and Allergy, University of Maryland School of Medicine, Baltimore, MD
Shawna Mudd, DNP, CRNP-AC, Acute/Chronic, Johns Hopkins University, Baltimore
Cassia Land, MS, School of Medicine, Johns Hopkins University, Baltimore, MD
Cheyenne McCray, BS, Division of General Pediatrics and Adolescent Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
Jean Ogborn, MD, Division of Pediatric Emergency Medicine, JHU School of Medicine, Baltimore
Arlene Butz, ScD, RN, CPNP, Harriet Lane Children's Health Bldg, The Johns Hopkins University School of Medicine, Baltimore, MD

Thirty nine percent of the workforce in the U.S. do not have access to paid sick days. The objective of this investigation is: 1) examine the relationship of caregiver employment status to asthma outcomes among inner city children; 2) examine employment status and perceptions of problems obtaining asthma care.


Data were obtained from an ongoing RCT testing efficacy of an educational/behavioral intervention delivered in the ED and home for 138 children aged 3-12 years, diagnosed with persistent asthma and having > 2 ED visits/past 12 months. Children were recruited during an ED visit where caregivers  provided reports of health, sociodemographics, and  employment status. Descriptive findings are examined followed by bivariate exploratory analyses of employment status and asthma outcomes (ED visits/past three months, ICU admissions, and asthma symptoms).


Children were primarily African American (95%), male (61.7%), young (mean age 6.22 )  Medicaid insured (96%) and residing with  caregivers (mean age 31)  who were single (76 %), earned  high school or more (81 %), employed (54%) and earned <$30,000 (67%).Twenty eight percent reported  asthma affecting employment possibilities. Of those employed (full or part time), 56% reported difficulty in leaving work to take their child to the doctor. Employment was not associated with asthma outcomes.  


Employed caregivers of inner city children with persistent asthma describe a complex experience balancing work and asthma demands.  Public health nurses have an important role in evaluating and advocating for policies related to paid sick leave for families with chronically ill children.

Learning Areas:

Public health or related nursing
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe caregiver characteristics of inner city children with persistent asthma. Describe the relationship of caregiver employment to asthma outcomes of children. Describe caregiver perceptions of balancing work and asthma demands. Discuss the relevance of sick leave policy in the care of chronically ill children.

Keyword(s): Asthma, Policy/Policy Development

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a co-investigator on this NINR grant focused on asthma outcomes in children. Among my interests has been the development of strategies to improve asthma outcomes in children especially by using PHN interventions in the community.
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.