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Social support and depression of the caregiver influence medication adherence and asthma control in children. Healthcare practitioners are encouraged to consider the social position of children with asthma and provide the appropriate type of family assistance, such as diagnosing and monitoring caregivers for signs of depression, and linking them with mental health resources.

Asthma is one of the most common childhood illnesses in the United States, but it disproportionately affects low-income, urban, Black children. According to a study published in the Journal of Racial and Ethnic Health Disparities these children are more likely to have asthma that is not under control, to miss school because of asthma, and to use health care because of asthma than their White, non-Hispanic, wealthy classmates. They are also more likely to die from the disease. Poorly controlled asthma can cause caregivers to miss pay and benefits, be unable to keep full-time employment, and experience psychological suffering. Moreover, the study found that 30–50% of mothers of low-income, urban, Black children with asthma had clinically significant depression symptoms.

This study aimed to examine the associations between caregiver social support, caregiver depressive symptoms, medication adherence, and asthma control in a population of low-income, urban, Black children aged 3 to 12 and their caregivers. Researchers utilized the longitudinal data from a randomized controlled trial (RCT) evaluating the efficacy of an environmental control educational intervention to examine the relationship between caregiver social support, depressive symptoms, and two child asthma outcomes: (a) medication adherence; and (b) asthma symptoms.

The study reported that over one-third of caregivers exhibited clinically severe depressive symptoms. Social support did not affect either asthma outcomes or the connection between depressive symptoms and child asthma outcomes. Lower medication adherence was predicted by higher caregiver depressive symptoms. Poorer asthma control was linked with moderate and severe asthma at baseline, a family annual income of $20,000 per year, and the fall season.
The severity of asthma was the best predictor of poor asthma control over time.

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Doctors and nurses should be made aware that poverty worsens asthma and affects Black children more than White children. Over time, the people in the intervention and control groups got better at taking their medicine and controlling their asthma. Based on this result, it seems likely that providing services at home to all caregivers and children may have helped improve these outcomes.

This study shows how important it is for healthcare professionals to understand the social situation of children with asthma and the need to provide the right kind of family support, such as assessing and keeping an eye on caregivers’ signs of depression and connecting them to mental health resources.

Further research into the associations between caregiver social support, caregiver depressive symptoms, and child asthma outcomes among low-income, urban, Black families is required to inform efforts to enhance asthma healthcare and well-being for this high-risk population.

Reference:
Margolis, R. H. F., Dababnah, S., Sacco, P., Jones-Harden, B., Bollinger, M. E., Butz, A., & Bellin, M. H. (2022). The Effects of Caregiver Social Support and Depressive Symptoms on Child Medication Adherence and Asthma Control. J Racial Ethn Health Disparities, 9(4), 1234-1242. doi:10.1007/s40615-021-01065-w