title: Race, socioeconomic factors, and area of residence are associated with asthma prevalence.
abstract: Asthma prevalence in the United States has been reported to be higher in minority groups such as Blacks and Hispanics. Because a disproportionate number of individuals from such minority groups are of low socioeconomic status (SES), it is unclear how much of the racial/ethnic differences in asthma prevalence is related to low SES. We investigated the effect of SES on the relationship between race/ethnicity and asthma prevalence in a cohort of families with a history of asthma or allergies from the Boston, Massachusetts area. From 499 families, a cohort of 998 parents and 307 children was identified. We used total yearly family income (<$50,000 vs. > or = $50, 000), highest level of education (< or = high school vs. > or = college), and residence in high-poverty areas vs. low-poverty areas as measures of SES. Yearly family income <$50,000, < or = high school education, and residence in high poverty areas were all associated with increased risks for asthma in both cohorts. In the parental cohort, Blacks and Hispanics (OR = 2.1, 95% CI = 1.5, 2.8; and OR = 2.2, 95% CI = 1.5, 3.2, respectively) were at greater risk for asthma than Whites. In the cohort of children, Black and Hispanic children (OR = 2.9, 95% CI = 1.0, 8.0; and OR = 5.3, 95% CI = 1.6, 17.5, respectively) were also at increased risk for asthma. When the three measures of SES were included in the multivariable models, the risks associated with Blacks and Hispanics decreased in both cohorts: OR = 1.4, 95% CI = 0.9, 2.0; and OR = 1.6, 95% CI = 1.0, 2. 6, respectively, for the parents; and OR = 0.8, 95% CI = 0.2, 3.0; and 2.5, 95% CI = 0.5, 11.7, respectively, for the children. We conclude that a large proportion of the racial/ethnic differences in asthma prevalence in our study is explained by factors related to income, area of residence, and level of education.
authors.affiliation: Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA. augusto.litonjua@channing.harvard.edu
authors.forename: A A
authors.initials: AA
authors.lastname: Litonjua
authors.forename: V J
authors.initials: VJ
authors.lastname: Carey
authors.forename: S T
authors.initials: ST
authors.lastname: Weiss
authors.forename: D R
authors.initials: DR
authors.lastname: Gold
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D017677:Age Distribution; D001213:Asian / Q000706:statistics & numerical data; D044466:Asian People; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology*; D044383:Black People; D001900:Boston / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012111:Residence Characteristics; D012307:Risk Factors; D017678:Sex Distribution; D012959:Socioeconomic Factors; D014505:Urban Population; D044465:White People / Q000706:statistics & numerical data