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To determine possible reasons for these associations, the researchers performed statistical analyses of pathways linking family support and neighborhood problems to asthma symptoms and lung function. They found that family support and asthma outcomes were linked via inflammation, but not behaviors. That is, low levels of family support were associated with greater inflammation, and, in turn, greater inflammation was associated with poorer asthma outcomes. In contrast, family support did not appear to change childrens behaviors.

Neighborhood problems and asthma symptoms were linked through behavioral pathways, but not through inflammation. The more problematic neighborhoods were associated with greater rates of child smoking and exposure to smoke. In turn, smoking was associated with poorer asthma outcomes. In contrast, neighborhood characteristics did not appear to change childrens inflammatory profiles.

Poor family relations may foster psychological experiences with direct physiologic consequences, whereas problematic neighborhoods may operate by providing role models for maladaptive behaviors, wrote Dr. Chen.

Interestingly, peer group support had no significant effects on asthma symptoms or lung function. These findings suggest that among children with asthma, family and ones neighborhood play a more important role in asthma morbidity than do peers.

Dr. Chen noted that the study group was small and that the cross-sectional design of the study precluded drawing a direct causal relationship, stressing that more research is necessary before drawing any definitive conclusions. If these findings are confirmed in future research, however, they could have important implications for asthma interventions. For example, interventions that target family interaction patterns may help improve childrens asthma by altering biological profiles. The neighborhood effects suggest the potential utilit
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