Strong family ties improve the asthma of the child

Do you want to help your child better fight against asthma? A new study from Northwestern University suggests that one way is to create a strong sense of family ties, especially in dangerous neighborhoods.

We already know that the health of children in poor neighborhoods is on average less good than that of children in better environments. However, little research has been done on how to minimize the negative impact of a dangerous neighborhood on a child's health. The current study led by Edith Chen provides a useful indicator in this regard.

Environmental exposure to physical air pollutants and allergy-inducing substances is important for inducing asthma symptoms in vulnerable children. However, this study shows that there are also social factors that contribute to the deterioration of asthma-related health in children. Among the most important of them is a difficult neighborhood.

The results of the study could help pediatricians offer families suggestions on how to manage their child's asthma. Image credit: Shutterstock

However, having a loving, trustworthy family can help children with asthma optimize their clinical outcomes even in poor neighborhood conditions, researchers have found in this study. The same buffer badociation did not come into play when the children lived in a safer and more orderly environment.

The study involved more than 300 Chicago children aged 9 to 17, who had all previously been diagnosed with asthma by a doctor. The streets in their neighborhood were examined using the Google Street View application. The virtual "walk" was designed to look for signs that the streets were safe and quiet, or vice versa.

Graffiti, barred windows, abandoned or decrepit cars and boarding houses were all evidence of the degradation and danger of the place of residence. This gave a more objective indication of the level of "danger and disorder" that participants were going through each day as they walked through their neighborhoods to and from home.

In addition, using tools such as interviews, questionnaires, spirometric lung function tests and blood tests, the researchers collected specific information in different areas. First, they asked about the outcome of asthma in each child. This was related to the nature and level of symptoms, the limitation of activity due to asthma and lung volume. Second, they looked at family behavior in relation to childhood asthma: did the family systematically support the child in managing their asthma and was there a generally positive family-child atmosphere? Finally, they evaluated biomarkers such as the number of certain immune cells and the response of these cells to the administration of glucocorticoids.

They found that children whose environment was predictable and safe tended to manage their asthma well, with little limitation of normal activity and satisfactory lung function, regardless of differences in level of support and of love that they had at home. But in dangerous neighborhoods, the immune system in asthmatic children appeared to be in a state of heightened vigilance, with immune cells showing increased production of cytokines and greater resistance to glucocorticoid inhibition.

However, with the poor quality of the neighborhood, the quality of family relationships has had obvious effects. The more the family had a positive score in terms of positive relationships, the better the children's asthma control. In such an environment, when the family helps the child manage their asthma on a daily basis, all asthma data show a positive trend.

Researcher Edith Chen said the research is important because most families need to stay in the community even though they live in difficult neighborhoods. However, she said: "When children live in highly threatened and disordered neighborhoods, the better their family relationships, the less they have symptoms and activity limitations and the better their lung function. If pediatricians can make suggestions to families about how supportive relationships can help manage their child's asthma, while acknowledging the realities of the persistent hardship faced by many of these families in the neighborhood, this could help families. "

Scientists do not know exactly how it works. They might badume, for example, that children whose families are a source of support and love are able to devote enough attention to managing their asthma symptoms with the help of their families. For example, other family members help them maintain their routine management, for example by taking their medications the right way and at the right time, perhaps by protecting them from negative or disruptive factors in the neighborhood . Further studies will be needed to confirm the mechanisms underlying the positive role of family and parenthood among young asthmatics living in a high-risk environment.

The study was published in the journal pediatrics July 18, 2019.