title: Mediators of the socioeconomic gradient in outcomes of adult asthma and rhinitis.
abstract: OBJECTIVE
  We estimated the extent to which socioeconomic status (SES) gradients in adult asthma and rhinitis outcomes can be explained by home and neighborhood environmental factors.
  
  
  METHODS
  Using survey data for 515 adults with either asthma or rhinitis, or both, we examined environmental mediators of SES associations with disease severity, using the Severity of Asthma Scale, and health-related quality of life (HRQL), using the Rhinasthma Scale. We defined SES on the basis of education and household income. Potential environmental mediators included home type and ownership, exposures to allergens and irritants, and a summary measure of perceived neighborhood problems. We modeled each outcome as a function of SES, and controlled for age, gender, and potential mediators.
  
  
  RESULTS
  Gradients in SES were apparent in disease severity and HRQL. Living in a rented house partially mediated the SES gradient for both severity and HRQL (P < .01). Higher perceived levels of neighborhood problems were associated with poorer HRQL and partially mediated the income-HRQL relationship (P < .01).
  
  
  CONCLUSIONS
  Differences in home and neighborhood environments partially explained associations of SES with adult asthma and rhinitis outcomes.
authors.affiliation: Department of Medicine, University of California, San Francisco, CA 94143-0920, USA. laura.trupin@ucsf.edu
authors.forename: Laura
authors.initials: L
authors.lastname: Trupin
authors.forename: Patricia P
authors.initials: PP
authors.lastname: Katz
authors.forename: John R
authors.initials: JR
authors.lastname: Balmes
authors.forename: Hubert
authors.initials: H
authors.lastname: Chen
authors.forename: Edward H
authors.initials: EH
authors.lastname: Yelin
authors.forename: Theodore
authors.initials: T
authors.lastname: Omachi
authors.forename: Paul D
authors.initials: PD
authors.lastname: Blanc
mesh_terms: D000328:Adult; D000368:Aged; D000485:Allergens / Q000032:analysis; D001249:Asthma / Q000453:epidemiology*; D002140:California / Q000453:epidemiology; D004781:Environmental Exposure; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012220:Rhinitis / Q000453:epidemiology*; D012720:Severity of Illness Index; D012923:Social Class; D011795:Surveys and Questionnaires
chemical_list: D000485:Allergens