Situating household management of children's asthma in the context of social, economic, and environmental injustice.
Pediatrics
control/management
Journal
The Journal of asthma : official journal of the Association for the Care of Asthma
ISSN: 1532-4303
Titre abrégé: J Asthma
Pays: England
ID NLM: 8106454
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
pubmed:
28
10
2020
medline:
22
4
2022
entrez:
27
10
2020
Statut:
ppublish
Résumé
Structural determinants of health are social, economic, and environmental forces that generate unequal opportunities for resources and unequally distribute exposure to risk. For example, economic constraint, racial discrimination and segregation, and environmental injustice shape population-level asthma prevalence and severity. Structural determinants are especially relevant to consider in clinical settings because they affect everyday household asthma management. To examine how structural determinants shape everyday household management of pediatric asthma and offer a framework for providers to understand asthma management in social context. Qualitative interviews of caregivers for children with asthma. Participants included 41 caregivers in two U.S. cities: St. Louis, Missouri ( We carried out narrative interviews with caregivers using an adapted McGill Illness Narrative Interview and using qualitative analysis techniques (e.g. inductive and deductive coding, constant comparison). Caregivers highlighted three ways that structural determinants complicated asthma management at home: 1) housing situations, 2) competing household illnesses and issues, and 3) multi-household care. By connecting social, economic, and environmental injustices to the everyday circumstances of asthma management, our study can help providers understand how social contexts challenge asthma management and can open conversations about barriers to adherence and strategies for supporting asthma management at home. We offer recommendations for medical system reform, clinical interactions, and policy advocacy.
Sections du résumé
BACKGROUND
BACKGROUND
Structural determinants of health are social, economic, and environmental forces that generate unequal opportunities for resources and unequally distribute exposure to risk. For example, economic constraint, racial discrimination and segregation, and environmental injustice shape population-level asthma prevalence and severity. Structural determinants are especially relevant to consider in clinical settings because they affect everyday household asthma management.
OBJECTIVE
OBJECTIVE
To examine how structural determinants shape everyday household management of pediatric asthma and offer a framework for providers to understand asthma management in social context.
DESIGN
METHODS
Qualitative interviews of caregivers for children with asthma.
PARTICIPANTS
METHODS
Participants included 41 caregivers in two U.S. cities: St. Louis, Missouri (
APPROACH
METHODS
We carried out narrative interviews with caregivers using an adapted McGill Illness Narrative Interview and using qualitative analysis techniques (e.g. inductive and deductive coding, constant comparison).
KEY RESULTS
RESULTS
Caregivers highlighted three ways that structural determinants complicated asthma management at home: 1) housing situations, 2) competing household illnesses and issues, and 3) multi-household care.
CONCLUSIONS
CONCLUSIONS
By connecting social, economic, and environmental injustices to the everyday circumstances of asthma management, our study can help providers understand how social contexts challenge asthma management and can open conversations about barriers to adherence and strategies for supporting asthma management at home. We offer recommendations for medical system reform, clinical interactions, and policy advocacy.
Identifiants
pubmed: 33107771
doi: 10.1080/02770903.2020.1837159
pmc: PMC8076336
mid: NIHMS1668354
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
70-78Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL137680
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002345
Pays : United States
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