Investigating the Association between Maternal Precarious Employment and Childhood Asthma Exacerbation

The rise in poor quality employment, also known as precarious employment, over the past few decades has posed many challenges, disproportionately affecting women, impacting both their wellbeing and their families. This cross-sectional study explored the association between maternal precarious employment and childhood asthma exacerbation, a leading cause of child hospitalizations in the United States. The data was drawn from the Panel Study of Income Dynamics (PSID) and a research component of the PSID, the Child Development Supplement (CDS) for the year of 2019. We analyzed employment quality among 543 participants who were mothers with children ages 4 to 17 who were diagnosed with asthma. Precarious employment was defined by combining four of the dimensions of employment quality (employment stability, material rewards, working time arrangements, and collective organization). The overall employment quality was then the unweighted sum of these four scores and was categorized into three groups: low (≤1), medium (>1 to 2), and high (>2 to 4) employment precarity. Asthma exacerbation was defined as children who have been to a hospital emergency room (ER) in the last 12 months and children who have missed school in the past 12 months due to asthma or wheezing. Logistic regression was used to calculate odds ratios and their accompanying 95% confidence intervals (95% CI). Our analysis found that children with mothers who had high employment precarity had a higher odds of emergency room (ER) visits due to asthma or wheezing in comparison to mothers who had low employment precarity (OR = 2.15, 95%CI: (1.22, 3.85)). Although the association between mothers who had medium employment precarity and childhood ER visits due to asthma or wheezing was null, the direction of the odds ratio suggested a higher odds of ER visits (OR = 1.70, 95% CI: (0.92, 3.19)). In the stratified analysis for maternal race/ethnicity (White and Non-White), the trends were similar to the previous models, showing an association between high employment precarity and higher odds of ER visits due to asthma or wheezing compared to low employment precarity for both White and Non-White groups. There was no significant association between maternal employment precarity and number of child school absences due to asthma or wheezing. This study can serve as a foundation for future research to inform interventions and policy makers about addressing precarious employment as a social determinant of child health outcomes.