Parents’ precarious work schedules and children’s asthma management

TL;DR

Unstable work schedules of parents are linked to worse asthma management in their children, highlighting a new social factor affecting child health.

Contribution

This study is the first to explore how parental work schedule instability affects children's asthma outcomes.

Findings

Parental exposure to unstable work schedules increases children's risk of wheezing and asthma-related emergency visits.

The negative effects are partially explained by parents' work-life conflict and reduced well-being.

These findings suggest that unstable work schedules may worsen health inequalities in children with asthma.

Abstract

Many working parents in the United States are employed in jobs that expose them to challenging working conditions, including low wages, limited benefits, and unstable and unpredictable work schedules. A growing body of literature has documented the harmful impacts of unstable and unpredictable scheduling on workers and their families. We focus on the connection between parental exposure to such unstable and unpredictable scheduling practices and children’s asthma management. Although not all risk factors are fully understood, researchers have linked genetics, environment, and social conditions to adequate asthma control. To this end, we estimate the association between parental exposure to unstable and unpredictable scheduling practices in the service sector and children’s asthma control.

This study draws on survey data from the Shift Project about children under the age of 10 whose parents are employed in the retail and service sectors (N=2,994). Using a series of OLS regressions with adjustment for confounders, we examine the association between parental exposure to unstable and unpredictable work schedules and their children’s asthma management. We also perform analyses to study whether parental health and well-being mediates this relationship.

We document that parental exposure to unstable and unpredictable scheduling practices heightens children’s risk of wheezing episodes and emergency department visits for asthma, with effect sizes of between 0.3 and 0.5 of a SD. The association between parental exposure to work schedule unpredictability and wheezing is significantly mediated by parental work-life conflict and well-being.

This study identifies a previously unexplored factor, parental exposure to unstable and unpredictable work schedules, that shapes children’s asthma management and adds to growing evidence on the consequences of schedule instability for the health and well-being of both workers and their children.

Ultimately, unstable work schedules among parents may further contribute to the already unequal distribution of asthma in children, ultimately exacerbating broader health inequalities in the United States.

The online version contains supplementary material available at 10.1186/s12889-026-26274-y.

Figures