Socioeconomic status and childhood asthma in urban minority youths. The GALA II and SAGE II studies.
BACKGROUND
The burden of asthma is highest among socioeconomically disadvantaged populations; however, its impact is differentially distributed among racial and ethnic groups.


OBJECTIVE
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 further examined whether acculturation explained the socioeconomic-asthma association in our Latino population.


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.
1 Department of Medicine.
Neeta
N
Thakur
Sam S
SS
Oh
Elizabeth A
EA
Nguyen
Melissa
M
Martin
Lindsey A
LA
Roth
Joshua
J
Galanter
Christopher R
CR
Gignoux
Celeste
C
Eng
Adam
A
Davis
Kelley
K
Meade
Michael A
MA
LeNoir
Pedro C
PC
Avila
Harold J
HJ
Farber
Denise
D
Serebrisky
Emerita
E
Brigino-Buenaventura
William
W
Rodriguez-Cintron
Rajesh
R
Kumar
L Keoki
LK
Williams
Kirsten
K
Bibbins-Domingo
Shannon
S
Thyne
Saunak
S
Sen
Jose R
JR
Rodriguez-Santana
Luisa N
LN
Borrell
Esteban G
EG
Burchard
D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data*; D001249:Asthma / Q000191:economics / Q000208:ethnology*; D016022:Case-Control Studies; D002648:Child; D004522:Educational Status; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data; D054525:Minority Health / Q000191:economics / Q000208:ethnology* / Q000706:statistics & numerical data; D016017:Odds Ratio; D012307:Risk Factors; D012495:San Francisco / Q000453:epidemiology; D012923:Social Class; D011795:Surveys and Questionnaires; D014504:Urban Health / Q000191:economics / Q000208:ethnology* / Q000706:statistics & numerical data; D055815:Young Adult