title: Socioeconomic status and asthma control in African American youth in SAGE II.
abstract: OBJECTIVE
  African Americans are disproportionately burdened by asthma. We assessed the individual and joint contribution of socioeconomic status (SES) on asthma morbidity among African American youth.
  
  
  METHODS
  We examined 686 African Americans (8-21 years) with asthma. To account for the joint effects of SES, a composite index was derived from maternal educational attainment, household income, and insurance status. Ordinal logistic regression was used to estimate the individual and joint effect of SES on asthma control. Models were adjusted for age, sex, controller medication use, in utero smoke exposure, family history of asthma, family history of rhinitis, breastfeeding, daycare attendance, and mold exposure.
  
  
  RESULTS
  Participants were classified as Poorly Controlled Asthma (40.8%), Partially Controlled Asthma (29.7%), or Controlled Asthma (30.2%). Of the individual SES indicators, low income was the strongest predictor of poor asthma control. Children with low income had worse asthma control than those with higher income (OR 1.39; 95% CI 0.92-2.12). The SES index ranged from 4-9. SES was associated with 17% increased odds of poor asthma control with each decrease in the index (95% CI 1.05-1.32). The SES index was associated with asthma-related symptoms, nocturnal awakenings, limited activity, and missed school days.
  
  
  CONCLUSIONS
  The negative effects of SES were observed along the entire socioeconomic gradient, and the adverse asthma outcomes observed in African American youth were not limited to the very poor. We also found that the SES index may be a more consistent and useful predictor of poor asthma outcomes than each indicator alone.
authors.affiliation: Department of Medicine, Division of Pulmonary and Critical Care Medicine .
authors.forename: Neeta
authors.initials: N
authors.lastname: Thakur
authors.forename: Melissa
authors.initials: M
authors.lastname: Martin
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Castellanos
authors.forename: Sam S
authors.initials: SS
authors.lastname: Oh
authors.forename: Lindsey A
authors.initials: LA
authors.lastname: Roth
authors.forename: Celeste
authors.initials: C
authors.lastname: Eng
authors.forename: Emerita
authors.initials: E
authors.lastname: Brigino-Buenaventura
authors.forename: Adam
authors.initials: A
authors.lastname: Davis
authors.forename: Kelley
authors.initials: K
authors.lastname: Meade
authors.forename: Michael A
authors.initials: MA
authors.lastname: LeNoir
authors.forename: Harold J
authors.initials: HJ
authors.lastname: Farber
authors.forename: Shannon
authors.initials: S
authors.lastname: Thyne
authors.forename: Saunak
authors.initials: S
authors.lastname: Sen
authors.forename: Kirsten
authors.initials: K
authors.lastname: Bibbins-Domingo
authors.forename: Luisa N
authors.initials: LN
authors.lastname: Borrell
authors.forename: Esteban G
authors.initials: EG
authors.lastname: Burchard
mesh_terms: D000293:Adolescent; D001741:Black or African American; D001249:Asthma / Q000191:economics / Q000208:ethnology* / Q000628:therapy; D002648:Child; D015986:Confounding Factors, Epidemiologic; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D011203:Poverty; D012923:Social Class; D014028:Tobacco Smoke Pollution; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution
keywords: Education; health status disparities; income; minority health; youth