title: Can economic deprivation protect health? Paradoxical multilevel effects of poverty on Hispanic children's wheezing.
abstract: Prior research suggests that economic deprivation has a generally negative influence on residents' health. We employ hierarchical logistic regression modeling to test if economic deprivation presents respiratory health risks or benefits to Hispanic children living in the City of El Paso (Texas, USA) at neighborhood- and individual-levels, and whether individual-level health effects of economic deprivation vary based on neighborhood-level economic deprivation. Data come from the US Census Bureau and a population-based survey of El Paso schoolchildren. The dependent variable is children's current wheezing, an established respiratory morbidity measure, which is appropriate for use with economically-deprived children with an increased likelihood of not receiving a doctor's asthma diagnosis. Results reveal that economic deprivation (measured based on poverty status) at both neighborhood- and individual-levels is associated with reduced odds of wheezing for Hispanic children. A sensitivity analysis revealed similar significant effects of individual- and neighborhood-level poverty on the odds of doctor-diagnosed asthma. Neighborhood-level poverty did not significantly modify the observed association between individual-level poverty and Hispanic children's wheezing; however, greater neighborhood poverty tends to be more protective for poor (as opposed to non-poor) Hispanic children. These findings support a novel, multilevel understanding of seemingly paradoxical effects of economic deprivation on Hispanic health.
authors.affiliation: Department of Sociology and Anthropology, University of Texas of El Paso, 500 West University Ave, El Paso, TX 79968, USA. twcollins@utep.edu.
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Collins
authors.affiliation: Department of Criminology, Law and Society, University of California Irvine, 2340 Social Ecology II, Irvine, CA 92697, USA. youngank@uci.edu.
authors.forename: Young-an
authors.initials: YA
authors.lastname: Kim
authors.affiliation: Department of Sociology and Anthropology, University of Texas of El Paso, 500 West University Ave, El Paso, TX 79968, USA. segrineski@utep.edu.
authors.forename: Sara E
authors.initials: SE
authors.lastname: Grineski
authors.affiliation: Department of Sociology and Anthropology, University of Texas of El Paso, 500 West University Ave, El Paso, TX 79968, USA. seclarkreyna@miners.utep.edu.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Clark-Reyna
mesh_terms: D000293:Adolescent; D002648:Child; D002947:Cities; D005260:Female; D054624:Health Status Disparities; D006630:Hispanic or Latino; D006801:Humans; D016015:Logistic Models; D008297:Male; D011203:Poverty; D012111:Residence Characteristics; D012135:Respiratory Sounds / Q000209:etiology; D012959:Socioeconomic Factors; D013781:Texas / Q000453:epidemiology
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