Caregiver Employment and Asthma Outcomes in Inner City Children with Persistent Asthma

Background

Thirty nine percent of the workforce in the U.S. do not have access to paid sick days. The objective of this investigation is: 1) examine the relationship of caregiver employment status to asthma outcomes among inner city children; 2) examine employment status and perceptions of problems obtaining asthma care.

Methods 

Data were obtained from an ongoing RCT testing efficacy of an educational/behavioral intervention delivered in the ED and home for 138 children aged 3-12 years, diagnosed with persistent asthma and having > 2 ED visits/past 12 months. Children were recruited during an ED visit where caregivers  provided reports of health, sociodemographics, and  employment status. Descriptive findings are examined followed by bivariate exploratory analyses of employment status and asthma outcomes (ED visits/past three months, ICU admissions, and asthma symptoms).

Results

Children were primarily African American (95%), male (61.7%), young (mean age 6.22 )  Medicaid insured (96%) and residing with  caregivers (mean age 31)  who were single (76 %), earned  high school or more (81 %), employed (54%) and earned <$30,000 (67%).Twenty eight percent reported  asthma affecting employment possibilities. Of those employed (full or part time), 56% reported difficulty in leaving work to take their child to the doctor. Employment was not associated with asthma outcomes.  

Conclusions  

Employed caregivers of inner city children with persistent asthma describe a complex experience balancing work and asthma demands.  Public health nurses have an important role in evaluating and advocating for policies related to paid sick leave for families with chronically ill children.