Physician Dayton Children's Hospital Dayton Children's Hospital Dayton, Ohio, United States
Background: Adverse childhood experiences are key drivers of negative pediatric health outcomes such as asthma and diabetes. Resilience is the process of obtaining healthy adaption after adversity and has individual, family and community elements. Family resilience is a key contributor to resilience in children due to the essential role of family in a child’s socio-emotional development. It evaluates how a family works through problems during difficult times. Objective: This study hypothesizes that family resilience mitigates the toxic health effects of adversity. Design/Methods: A cross-sectional observational study was conducted on data collected from children aged 4 to 17 years from the 2020-2021 National Survey of Children’s Health (NSCH). The NSCH is conducted by the Census Bureau and randomly selects households from all 50 states and the District of Columbia. Within households, 1 child is randomly selected for questionnaires on a wide range of indicators pertaining to health and wellbeing. Primary outcomes of the study were the presence of asthma or diabetes. Family resilience was stratified into high, moderate and low levels based on responses to 4 survey items. Adverse Childhood Experiences (ACEs) were stratified into 0, 1-3 and 4-10 based on responses to 10 ACEs questions. Multiple logistic regression was used to determine adjusted odds ratios (AOR) and 95% confidence intervals (CI) for the effects of family resilience and adverse childhood experiences on presence of asthma or diabetes. This study adjusted for the effects of age, sex, race/ethnicity, health insurance coverage, parent education and family poverty level. The modifying effect of family resilience on the association between ACEs and pediatric asthma or diabetes was determined Data analysis was performed with SPSS Statistics for Windows, Version 29 Complex Samples module with weighting. Results: 70,832 children representing a population of 54,886,990 were included. The weighted overall response rate was 42.4% and 40.3% in 2020 and 2021 respectively. 12.7% and 0.5% of the population reported having asthma and diabetes respectively. High adversity increased the AORs of pediatric asthma and diabetes. Low resilience increased the AOR of diabetes (Table 1). Resilience modifies the association between adversity and asthma and diabetes. Children with low family resilience and high adversity have increased AORs of asthma and diabetes compared to children with high family resilience and high adversity (Tables 2 and 3).
Conclusion(s): High family resilience buffers the effect of adversity on asthma and diabetes in children.
.png)
.png)
.png)