title: Multiple urban and asthma-related risks and their association with asthma morbidity in children.
abstract: OBJECTIVE
  To determine whether a multi-dimensional cumulative risk index (CRI) is a stronger predictor of asthma morbidity in urban, school-aged children with asthma, than poverty or severity alone.
  
  
  METHODS
  A total of 163 children with asthma, ages 7-15 years (42% female; 69% ethnic minority) and their primary caregivers completed interview-based questionnaires, focusing on potential cultural, contextual, and asthma-specific risks that can impact asthma morbidity.
  
  
  RESULTS
  Higher levels of cumulative risks were associated with more asthma morbidity, after controlling for poverty level or asthma severity. Analyses by ethnic group and subgroup also supported the relationship between the CRI and specific indices of asthma morbidity.
  
  
  CONCLUSIONS
  This study demonstrates the utility of multiple-dimensional risk models for predicting variations in asthma morbidity in urban children. Research efforts with urban families who have children with asthma need to consider the context of urban poverty as it relates to children's cultural backgrounds and specific asthma outcomes.
authors.affiliation: Child and Family Psychiatry, Bradley/Hasbro Research Center, Brown Medical School, 1 Hoppin Street, Coro West, 2nd Floor, Providence, RI 02903, USA. Daphne_Koinis-Mitchell@Brown.edu
authors.forename: Daphne
authors.initials: D
authors.lastname: Koinis-Mitchell
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: McQuaid
authors.forename: Ronald
authors.initials: R
authors.lastname: Seifer
authors.forename: Sheryl J
authors.initials: SJ
authors.lastname: Kopel
authors.forename: Cynthia
authors.initials: C
authors.lastname: Esteban
authors.forename: Glorisa
authors.initials: G
authors.lastname: Canino
authors.forename: Cynthia
authors.initials: C
authors.lastname: Garcia-Coll
authors.forename: Robert
authors.initials: R
authors.lastname: Klein
authors.forename: Gregory K
authors.initials: GK
authors.lastname: Fritz
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000453:epidemiology* / Q000503:physiopathology*; D002648:Child; D003710:Demography; D004781:Environmental Exposure / Q000009:adverse effects* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data*