A chaotic household, which lacks organization and routine, is noisy and where relaxation is difficult, is a risk factor for worse asthma outcomes in urban minority children, suggests results from the Asthma Action at Erie Trial published in the July 2019 issue of the journal Pediatrics. Along with this, depression in the child and the parent was also identified as a risk factor.  

Researchers analyzed the association between parent, child and family functioning and child asthma control in urban minority youth with uncontrolled asthma. Family chaos was evaluated using a 15-item questionnaire that asked respondents to rate statements such as "No matter how hard we try, we always seem to be running late;" "We can usually find things when we need them;" "We always seem to be rushed;" and "Our home is a good place to relax." The relationship between parent depression and post-traumatic stress disorder (PTSD) symptoms and child depression and PTSD symptoms was also examined.

Parent and childhood depressive symptoms, but not PTSD symptoms, were associated with worse child asthma control. Higher levels of family chaos were found to be associated with worse child asthma control even when the researchers controlled for parent and child depression. The study concluded that family chaos may explain the association of parental depression and child asthma control.

This study adds to the list of evidence, which shows that social factors “social determinants of health” also influence the health outcomes. Conditions we live in and work also affect our health.

These social determinants of health have rightly been called “the causes of the causes”, which implies that to eliminate a problem, its root causes must be addressed first. Effective care cannot be delivered, if these factors are not taken into consideration.

So, treat not just the disease, but the individual patient in context of his/her social circumstances.

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA