Adverse childhood experiences and risk factors associated with asthma among children in the United States: the intersection of sex and race/ethnicity

Objective The objectives of this cross-sectional study were to examine: 1) the association between adverse childhood experiences (ACEs) and asthma among children, and 2) the interaction between sex and race/ethnicity on asthma. Methods Data for this study were obtained from the 2017-2018 National Survey of Children's Health. Binary logistic regression was conducted on an analytic sample of 49,000 children ages 0-17 years with asthma as the outcome variable and ACEs as the main explanatory variable. Results Based on parent reports, we found that 11.5% of children had asthma and about 42% had at least one ACE, with 9.7% having >= 3 ACEs. Controlling for other factors, children with >= 3 ACEs had 1.45 times higher odds of having asthma when compared to children with no ACEs. Non-Hispanic Black males and females were more likely to have asthma when compared to non-Hispanic White males. Conclusions The findings of this study demonstrate an association between ACEs and asthma with children exposed to >= 3 ACEs more likely to have asthma underscoring the importance of cumulative effect of ACEs on asthma. Our study also revealed an interaction between sex and race/ethnicity on asthma among children. Additional studies are needed to understand the mechanisms through which ACEs is associated with asthma among children.