Socioeconomic status and childhood asthma in urban minority youths. The GALA II and SAGE II studies

Abstract

Rationale: The burden of asthma is highest among socioeconomically disadvantaged populations; however, its impact is differentially distributed among racial and ethnic groups.

Objectives: 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.

Measurements and main 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.

Figure 1.

The adjusted odds ratio for asthma along the SES Index by race and ethnicity. Adjusted for age, sex, and secondhand smoke exposure. SES = socioeconomic status.

Figure 2.

The predicted prevalence (%) of asthma based on the current asthma prevalence for each racial and ethnic group in the United States along the SES index. SES = socioeconomic status.

Figure 3.

The adjusted odds of current asthma for each decrease in the composite socioeconomic index stratified by Latino Subgroup (Composite SES Index). Mediation via acculturation shows the odds of current asthma for each decrease in the Composite SES Index with the addition of acculturation to the multivariable regression model. All models adjusted for age, sex, and secondhand smoke exposure. SES = socioeconomic status.