Journal
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
Volume 188, Issue 10, Pages 1202-1209Publisher
AMER THORACIC SOC
DOI: 10.1164/rccm.201306-1016OC
Keywords
asthma; health status disparities; minority health; educational status; poverty
Categories
Funding
- National Institutes of Health [R01-ES015794, U19-AI077439, R01-HL088133, R01-HL078885, R01-HL104608]
- National Institute on Minority Health and Health Disparities of the National Institutes of Health [P60-MD006902, M01-RR00188, R01-AI079139, R01-DK064695, R01-HL079055, R01-AI061774]
- Flight Attendant Medical Research Institute
- Sandler Foundation
- RWJF Amos Medical Faculty Development Award
- American Asthma Foundation
- Ernest S. Bazley Grant
- NIGMS [T32-GM007546]
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Rationale: The burden of asthma is highest among socioeconomically disadvantaged populations; however, its impact is differentially distributed among racial and ethnic groups. Objectives: To assess the collective effect of maternal educational attainment, annual household income, and insurance type on childhood asthma among minority, urban youth. Methods: We included Mexican American (n = 485), other Latino (n = 217), and African American (n = 1,141) children (aged 8-21 yr) with and without asthma from the San Francisco Bay Area. An index was derived from maternal educational attainment, annual household income, and insurance type to assess the collective effect of socioeconomic status on predicting asthma. Logistic regression stratified by racial and ethnic group was used to estimate adjusted odds ratios (aOR) and their 95% confidence intervals (CI). We [GRAPHICS] further examined whether acculturation explained the socioeconomic-asthma association in our Latino population. Measurements and Main Results: In the adjusted analyses, African American children had 23% greater odds of asthma with each decrease in the socioeconomic index (aOR, 1.23; 95% CI, 1.09-1.38). Conversely, Mexican American children have 17% reduced odds of asthma with each decrease in the socioeconomic index (aOR, 0.83; 95% CI, 0.72-0.96) and this relationship was not fully explained by acculturation. This association was not observed in the other Latino group. Conclusions: Socioeconomic status plays an important role in predicting asthma, but has different effects depending on race and ethnicity. Further steps are necessary to better understand the risk factors through which socioeconomic status could operate in these populations to prevent asthma.
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