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Background: Single-parenthood has been associated with increased asthma prevalence, but studies have not addressed its effect on asthma-related morbidity among children.Objective: To characterize whether single-parenthood is associated with repeat pediatric asthma-related healthcare use and to examine characteristics of single-parent families that may explain this relationship.Hypothesis: Pediatric patients hospitalized with asthma or wheezing who come from homes with married parents will be at increased odds of a repeat asthma-related hospitalization or emergency room (ER) visit within 12 months of an index admission than children from homes with single-parents. Specific Aim 1: Identify single-parenthood as a novel risk factor for repeat asthma-related hospitalization or ER visit within 12 months of an index admission in a cohort of pediatric patients admitted for asthma or wheezing.Specific Aim 2: Examine characteristics of single-parent homes, including household income, psychological distress, ratio of children to adults in the home, and child's time spent outside the home that may contribute to the increased risk of repeat asthma-related admission/ER visit in a cohort of pediatric patients admitted for asthma or wheezing.Methods: We analyzed a prospective cohort of 601 children aged 1-16 years admitted for asthma or wheezing. The primary outcome was an asthma-related admission or emergency room visit within 12 months of the index admission. Caregiver marital status was assessed along with psychosocial strain variables: household income, psychological distress, ratio of children to adults in the home, and child's time spent outside the home. Results: Forty-percent returned to the hospital for asthma within 12 months. Fifty-nine percent of caregivers described themselves as single-parents. Compared to children of married parents, children of single-parents were more likely to return to the hospital (43% vs. 34%, p=0.04). Children from homes with income Conclusion: Among children admitted for asthma or wheezing, those from single-parent homes were 50% more likely to return to the hospital within 12 months. This relationship may result from lower income and increased psychological distress in single-parent homes.