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Chest. 2017 Apr;151(4):804-812. doi: 10.1016/j.chest.2016.11.027. Epub 2016 Dec 1.

Perceived Discrimination Associated With Asthma and Related Outcomes in Minority Youth: The GALA II and SAGE II Studies.

Author information

1
Department of Medicine, University of California, San Francisco, San Francisco.
2
Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York. Electronic address: luisa.borrell@sph.cuny.edu.
3
Children's Hospital Oakland Research Institute, UCSF Benioff Children's Hospital, Oakland, CA.
4
Bay Area Pediatrics, Oakland, CA.
5
Department of Medicine, Northwestern University, Chicago, IL.
6
Department of Pediatrics, Section of Pulmonology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX.
7
Pediatric Pulmonary Division, Jacobi Medical Center, Bronx, NY.
8
Department of Allergy and Immunology, Kaiser Permanente Vallejo Medical Center, Vallejo.
9
Veterans Caribbean Health Care System, San Juan, Puerto Rico.
10
Department of Pediatrics, University of California, Los Angeles, Los Angeles, CA.
11
Centro de Neumología Pediátrica, San Juan, Puerto Rico.
12
Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN.
13
Department of Medicine, University of California, San Francisco, San Francisco; Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco.

Abstract

BACKGROUND:

Asthma disproportionately affects minority populations and is associated with psychosocial stress such as racial/ethnic discrimination. We aimed to examine the association of perceived discrimination with asthma and poor asthma control in African American and Latino youth.

METHODS:

We included African American (n = 954), Mexican American (n = 1,086), other Latino (n = 522), and Puerto Rican Islander (n = 1,025) youth aged 8 to 21 years from the Genes-Environments and Admixture in Latino Americans study and the Study of African Americans, Asthma, Genes, and Environments. Asthma was defined by physician diagnosis, and asthma control was defined based on the National Heart, Lung, and Blood Institute guidelines. Perceived racial/ethnic discrimination was assessed by the Experiences of Discrimination questionnaire, with a focus on school, medical, and public settings. We examined the associations of perceived discrimination with each outcome and whether socioeconomic status (SES) and global African ancestry modified these associations.

RESULTS:

African American children reporting any discrimination had a 78% greater odds of experiencing asthma (OR, 1.78; 95% CI, 1.33-2.39) than did those not reporting discrimination. Similarly, African American children faced increased odds of poor asthma control with any experience of discrimination (OR, 1.97; 95% CI, 1.42-2.76) over their counterparts not reporting discrimination. These associations were not observed among Latino children. We observed heterogeneity of the association between reports of discrimination and asthma according to SES, with reports of discrimination increasing the odds of having asthma among low-SES Mexican American youth (interaction P = .01) and among high-SES other Latino youth (interaction P = .04).

CONCLUSIONS:

Perceived discrimination is associated with increased odds of asthma and poorer control among African American youth. SES exacerbates the effect of perceived discrimination on having asthma among Mexican American and other Latino youth.

KEYWORDS:

children; health status disparity; psychosocial stress; race; socioeconomic status

PMID:
27916618
PMCID:
PMC5472516
DOI:
10.1016/j.chest.2016.11.027
[Indexed for MEDLINE]
Free PMC Article

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