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Will Your Child Develop Asthma? Researchers Identify 3 Major Risk Factors

A Black girl using an inhaler, next to a Black doctor or nurse and a parent.

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Key Takeaways

  • A study found that sex, race, and family history can play a role in the development of asthma.
  • Black children were more likely to develop asthma than White children.
  • Children who lived in cities developed asthma at higher rates than children who lived in rural areas.

A new study examining childhood asthma found that family history, race, and sex can all lead to higher rates of asthma in children.

The May study published in JAMA Pediatrics looked to see what role these factors play in the development of asthma in the United States. The researchers analyzed data collected from 1980 to 2018 that included over 11,000 children.

The researchers found that:

  • Children with a family history of asthma had a two-fold increase risk of asthma at age 4 compared to those without a family history and continued to have a higher risk through age 14
  • Boys with a family history of asthma had higher rates of asthma than girls in their early years. By age 14, their rate of incidence was about the same
  • Black children had the highest rates of asthma regardless of family history

They also found that Black children with asthma were more likely to have a family history of asthma and lived in an urban setting. Black children were more likely to develop asthma around the time that they were in preschool, and White children were more likely to develop asthma later in childhood.

Experts say this data is consistent with previous research on asthma in children.

"Children with a family history of asthma had two to three times the rates of asthma through the age of four, that's not necessarily new," Karen L. Meyerson, MSN, FNP-C, director of commercial care management at Priority Health, tells Verywell. "We know that the rates for boys declined as they got older and then the rates for girls in this study [were] pretty steady."

Environmental Risks for Asthma

The study found that people with a family history of asthma were more likely to live in urban areas. A family history of asthma may exacerbate environmental factors that potentially already influence the development of the condition.

"They [children in urban areas] have a much higher incidence of asthma, compared to kids who live in rural areas and are exposed to farm animals and things of that nature," Sanjeev Jain, MD, PhD, allergist and immunologist and CEO of Columbia Allergy, tells Verywell.

In addition to not being as exposed to allergens found in more rural or suburban areas, research also suggests that other factors may exacerbate asthma for kids who live in inner cities.

A 2018 review published in the Current Opinion in Allergy and Clinical Immunology journal found that greater tobacco smoke exposure in cities could increase asthma in children. Socioeconomic status also played a role. "Socioeconomic hardship explained more than half of the asthma readmission risk," they wrote.

These Findings Have Some Limitations

The research does have some limitations. Jain notes that researchers for this study did not track the occurrence of asthma into adulthood. They also didn't analyze the connection between asthma and allergies.

Children who develop early-onset asthma in conjunction with allergies may see their asthma return in adulthood, Jain explains. "Those kids have a few years of relief of their asthma in association with their growth spurt and puberty, and then later on when you follow those same kids in adulthood, those kids then ultimately have a recurrence of their asthma," he says.

Previous research supports this. A 2014 study published in the Respiratory Research journal found that among people in southern Taiwan, adults with early-onset asthma were more likely to have a relapse of asthma in adulthood than people with late-onset asthma, who developed asthma after the age of 12. "Age-related lung function loss, environmental factors, etc. may contribute to this phenomenon," the researchers wrote.

What This Means For You

In young children, it can be difficult for parents to recognize when symptoms are a result of asthma. If symptoms like coughing or wheezing keep occurring, this can be a sign of the condition. If anyone in your family has asthma or allergies, there's more of a chance that your child may be diagnosed with the condition too.

Asthma Can Present In Different Ways

For people who do not have a family history of asthma, it may be difficult to spot it in a child, especially if they are showing atypical symptoms. "If you have a baby who was under three and has frequent wheezing episodes, even, especially if they're [being] treated, and they're lasting more than a couple of days, that baby is more likely to go on to develop lifelong asthma," Meyerson says.

She adds that it is crucial for healthcare providers to become more aware of the different ways asthma can present itself in order to better diagnose and treat it. For example, Meyerson says, a person that responds well to medications used to treat asthma, like inhalers, may have the condition even if they're not exhibiting the most common signs.

According to the American College of Allergy, Asthma, and Immunology, asthma in children may appear like they have a cold or bronchitis. Common symptoms of asthma in children include:

  • Coughing, especially at night
  • A wheezing or whistling sound, especially when breathing out
  • Trouble breathing or fast breathing that causes the skin around the ribs or neck to pull in tightly
  • Frequent colds that settle in the chest
  • Worsened symptoms around asthma triggers like smokes or allergens like dust mites
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  1. Johnson CC, Chandran A, Havstad S, et al. US childhood asthma incidence rate patterns from the ECHO Consortium to identify high-risk groups for primary preventionJAMA Pediatr. Published online May 17, 2021. doi:10.1001/jamapediatrics.2021.0667

  2. Dutmer C, Kim H, Searing D, Zoratti E, Liu A. Asthma in inner city children: recent insights: United StatesCurr Opin Allergy Clin Immunol. 2018;18(2):139-147. doi:10.1097/aci.0000000000000423

  3. Wu T-J, Wu C-F, Lee YL, Hsiue T-R, Guo YL. Asthma incidence, remission, relapse and persistence: a population-based study in southern TaiwanRespir Res. 2014;15(1):135. doi:10.1186/s12931-014-0135-9

  4. American College of Allergy, Asthma, and Immunology. Asthma in children. Updated December 31, 2018.