title: Asthma control and obesity in urban African American children.
abstract: OBJECTIVE
  To examine the relationship between body mass index (BMI), gender, age, controller medication use, household smoke exposure, season, and allergic rhinitis status with asthma control in a group of lower income, African American children. We hypothesized that non-obese children would have better asthma control.
  
  
  METHODS
  Baseline data from a longitudinal study of children in a school-based asthma program in a Midwest urban area were analyzed. 360 children, ages 4-15 years, who were enrolled in either the 2012-2013 or 2013-2014 program were included. Asthma control was classified using criteria from the 2007 National Asthma Education and Prevention Program. Multiple ordinal regression was performed.
  
  
  RESULTS
  The median age was 9 years, 61% had well-controlled asthma, and 29% were obese. The model included all main effects plus two interaction terms and was significant (χ2(7) = 22.17, p =.002). Females who were normal weight (OR, 2.78; 95% CI, 1.38-5.60, p =.004) or overweight (OR, 3.12; 95% CI, 1.26-7.72, p =.014) had better asthma control than obese females. For males, there were no differences by BMI category but males without allergic rhinitis had significantly better asthma control (OR, 2.23; 95% CI, 1.25-3.97, p =.006) than those with allergic rhinitis.
  
  
  CONCLUSIONS
  Non-obese girls and non-allergic males had better asthma control. Promotion of healthy activity and nutrition as well as management of allergic rhinitis should be part of the asthma plan in school-based programs in low income urban areas. Innovative approaches to address asthma care in low income populations are essential.
authors.affiliation: a Saint Louis University School of Nursing , St. Louis , Missouri , USA.
authors.forename: Deborah G
authors.initials: DG
authors.lastname: Loman
authors.affiliation: b Department of Pediatrics , Washington University School of Medicine , St. Louis , Missouri , USA.
authors.forename: Christina G
authors.initials: CG
authors.lastname: Kwong
authors.affiliation: c St. Louis Children's Hospital , St. Louis , Missouri , USA.
authors.forename: Lisa D
authors.initials: LD
authors.lastname: Henry
authors.affiliation: c St. Louis Children's Hospital , St. Louis , Missouri , USA.
authors.forename: Christina
authors.initials: C
authors.lastname: Mahl
authors.affiliation: c St. Louis Children's Hospital , St. Louis , Missouri , USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Meadows
authors.affiliation: b Department of Pediatrics , Washington University School of Medicine , St. Louis , Missouri , USA.
authors.forename: Alysa G
authors.initials: AG
authors.lastname: Ellis
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D001249:Asthma / Q000208:ethnology* / Q000503:physiopathology*; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009765:Obesity / Q000208:ethnology*; D050177:Overweight / Q000208:ethnology; D011203:Poverty / Q000706:statistics & numerical data; D065631:Rhinitis, Allergic / Q000208:ethnology*; D012621:Seasons; D012720:Severity of Illness Index; D012737:Sex Factors; D014028:Tobacco Smoke Pollution / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data*
chemical_list: D014028:Tobacco Smoke Pollution
keywords: Allergic rhinitis; gender; household smoke; low-income; obesity; pediatrics; urban