Exploring the Connection: Childhood Violence and Asthma Persistence in Puerto Rican Adults

September 22, 2023

Celedón Laboratory Awarded New NIH R01 Grant to Continue Studies of Interplay Between Psychosocial Stressors and Asthma

UPMC Children’s Hospital of Pittsburgh Division of Pediatric Pulmonary Medicine division chief Juan C. Celedón, MD, DrPH, ATSF, was awarded a new National Institutes of Health R01 grant that will continue and further his laboratory’s investigations of how exposure to violence and other psychosocial stressors influence the manifestations, trajectory, and response to treatment in children and adults with asthma.

Background and Previous Findings

Asthma remains one of the most prevalent chronic conditions in children, affecting millions worldwide. Asthma disproportionately affects certain racial and ethnic groups in the United States, with Puerto Ricans experiencing notably higher prevalence than other groups. Socioeconomically disadvantaged communities also face higher asthma rates, often due to urban living, indoor allergens exposure, and limited health care access.

Beyond mere prevalence, the severity and control of asthma present added challenges for these groups. For example, African Americans and Puerto Ricans experience more severe asthma manifestations, contributing to higher hospitalization morbidity rates. Socioeconomic factors also play a significant role, with individuals from lower-income backgrounds often struggling with effective asthma control due to various factors, such as limited access to care, medication affordability, and greater exposure to environmental triggers. This intersection of ethnicity, socioeconomic status, and environmental factors creates a complex landscape for asthma management and outcomes and underscores the need for targeted research.

Dr. Celedon's and colleagues’ previous research has found that psychosocial stressors, such as child maltreatment and exposure to violence, correlate with major depressive disorder (MDD) and generalized anxiety disorder (GAD). Interestingly, these behavioral health conditions have also shown associations with asthma and adverse asthma outcomes in Puerto Ricans.

Another key finding from earlier studies by Dr. Celedon’s team is the connection between violence-related distress and reduced bronchodilator efficacy. Additionally, high levels of exposure to violence and associated distress have been tied to asthma in Puerto Rican youth with biomarkers of high Th2 immunity.

Aims of the New Research

The crux of the study revolves around two main questions: Does childhood exposure to violence cause a Th2-high asthma endotype to persist into adulthood? And what role do MDD and GAD play in this context among young Puerto Rican adults?

In order to answer these questions, Dr. Celedón’s research will work to determine the association between high childhood exposure to violence and persistent Th2-high asthma in young adults. It will also examine the link between childhood exposure to violence and the prevalence of MDD or GAD in this population while investigating the relationship between MDD or GAD and asthma severity or control.

Why It Matters

This study holds potential ramifications for public health policy and asthma management. If a tangible link between childhood violence and persistent asthma is validated, it could emphasize the importance of integrating psychosocial support into asthma care, especially in vulnerable communities. Moreover, such findings could drive societal and community-level interventions to mitigate exposure to violence as a measure against persistent asthma.

With Puerto Ricans and other minority populations facing higher risks of asthma or worse disease trajectories, insights from this study could lead to better prevention and management strategies.

The interplay between social determinants and health outcomes is complex, and Dr. Celedón's lab seeks to shed light on this dynamic. As asthma rates continue to be disproportionately high in minority and disadvantaged populations, findings from this study could provide a roadmap for better prevention, understanding, and management of the condition.

Further Reading

Learn more about the Celedón Laboratory, the research team, and their ongoing investigations into the causes of asthma.