title: Perceived Discrimination Associated With Asthma and Related Outcomes in Minority Youth: The GALA II and SAGE II Studies.
abstract: Asthma disproportionately affects minority populations and is associated with psychosocial stress such as racial/ethnic discrimination. We aimed to examine the association of perceived discrimination with asthma and poor asthma control in African American and Latino youth.
  
  
  
  We included African American (n = 954), Mexican American (n = 1,086), other Latino (n = 522), and Puerto Rican Islander (n = 1,025) youth aged 8 to 21 years from the Genes-Environments and Admixture in Latino Americans study and the Study of African Americans, Asthma, Genes, and Environments. Asthma was defined by physician diagnosis, and asthma control was defined based on the National Heart, Lung, and Blood Institute guidelines. Perceived racial/ethnic discrimination was assessed by the Experiences of Discrimination questionnaire, with a focus on school, medical, and public settings. We examined the associations of perceived discrimination with each outcome and whether socioeconomic status (SES) and global African ancestry modified these associations.
  
  
  
  African American children reporting any discrimination had a 78% greater odds of experiencing asthma (OR, 1.78; 95% CI, 1.33-2.39) than did those not reporting discrimination. Similarly, African American children faced increased odds of poor asthma control with any experience of discrimination (OR, 1.97; 95% CI, 1.42-2.76) over their counterparts not reporting discrimination. These associations were not observed among Latino children. We observed heterogeneity of the association between reports of discrimination and asthma according to SES, with reports of discrimination increasing the odds of having asthma among low-SES Mexican American youth (interaction P = .01) and among high-SES other Latino youth (interaction P = .04).
  
  
  
  Perceived discrimination is associated with increased odds of asthma and poorer control among African American youth. SES exacerbates the effect of perceived discrimination on having asthma among Mexican American and other Latino youth.
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco.
authors.forename: Neeta
authors.initials: N
authors.lastname: Thakur
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco.
authors.forename: Nicolas E
authors.initials: NE
authors.lastname: Barcelo
authors.affiliation: Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York. Electronic address: luisa.borrell@sph.cuny.edu.
authors.forename: Luisa N
authors.initials: LN
authors.lastname: Borrell
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco.
authors.forename: Smriti
authors.initials: S
authors.lastname: Singh
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco.
authors.forename: Celeste
authors.initials: C
authors.lastname: Eng
authors.affiliation: Children's Hospital Oakland Research Institute, UCSF Benioff Children's Hospital, Oakland, CA.
authors.forename: Adam
authors.initials: A
authors.lastname: Davis
authors.affiliation: Children's Hospital Oakland Research Institute, UCSF Benioff Children's Hospital, Oakland, CA.
authors.forename: Kelley
authors.initials: K
authors.lastname: Meade
authors.affiliation: Bay Area Pediatrics, Oakland, CA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: LeNoir
authors.affiliation: Department of Medicine, Northwestern University, Chicago, IL.
authors.forename: Pedro C
authors.initials: PC
authors.lastname: Avila
authors.affiliation: Department of Pediatrics, Section of Pulmonology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX.
authors.forename: Harold J
authors.initials: HJ
authors.lastname: Farber
authors.affiliation: Pediatric Pulmonary Division, Jacobi Medical Center, Bronx, NY.
authors.forename: Denise
authors.initials: D
authors.lastname: Serebrisky
authors.affiliation: Department of Allergy and Immunology, Kaiser Permanente Vallejo Medical Center, Vallejo.
authors.forename: Emerita
authors.initials: E
authors.lastname: Brigino-Buenaventura
authors.affiliation: Veterans Caribbean Health Care System, San Juan, Puerto Rico.
authors.forename: William
authors.initials: W
authors.lastname: Rodriguez-Cintron
authors.affiliation: Department of Pediatrics, University of California, Los Angeles, Los Angeles, CA.
authors.forename: Shannon
authors.initials: S
authors.lastname: Thyne
authors.affiliation: Centro de Neumología Pediátrica, San Juan, Puerto Rico.
authors.forename: Jose R
authors.initials: JR
authors.lastname: Rodriguez-Santana
authors.affiliation: Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN.
authors.forename: Saunak
authors.initials: S
authors.lastname: Sen
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Bibbins-Domingo
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco; Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco.
authors.forename: Esteban Gonzalez
authors.initials: EG
authors.lastname: Burchard
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000523:psychology*; D001249:Asthma / Q000208:ethnology* / Q000523:psychology*; D016022:Case-Control Studies; D002648:Child; D005260:Female; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008297:Male; D063505:Racism; D012307:Risk Factors; D012923:Social Class; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult
keywords: children; health status disparity; psychosocial stress; race; socioeconomic status