Longitudinal relationships between early-life homelessness and school-aged asthma and wheezing

Abstract

BackgroundHomelessness is a disruptive life event with profound impacts on children’s health. It remains unclear, however, whether homelessness in early life has an enduring association with asthma and wheezing among school-aged children.ObjectiveTo test whether early-life homelessness is prospectively associated with asthma and wheezing during school-aged years.MethodsWe draw on data from 9242 children from the Avon Longitudinal Study of Parents and Children. Children were categorised as ‘ever’ or ‘never’ homeless based on maternal reports from the prenatal period through age 5 years. Children were assigned a binary indicator of asthma/wheezing based on maternal reports of asthma and wheezing at ages 6.8, 7.6 and 8.6 years. We used multilevel logistic regression models to test the association of interest in both bivariate analyses and models adjusted for a broad set of potential confounders. We conducted sensitivity analyses using generalised estimating equations and considering asthma and wheezing separately to test the robustness of the results.ResultsBetween 12.1% and 14.3% of children had asthma or wheezing at ages 6.8, 7.6 and 8.6 years, and these conditions were more common among ever homeless participants. Ever-homeless children displayed higher odds of asthma or wheezing than never-homeless children (OR: 1.59, 95% CI 1.02 to 2.48) after adjustment for child, maternal and household risk factors. Sensitivity analyses yielded similar results.ConclusionEarly-life homelessness is prospectively associated with asthma and wheezing among school-aged children and should be prioritised by interventions promoting healthy child development.