Revisiting the Hispanic health paradox: the relative contributions of nativity, country of origin, and race/ethnicity to childhood asthma

Abstract

This study examined the relationship between race and Hispanic ethnicity, maternal and child nativity, country of origin and asthma among 2,558 non-Hispanic white and Hispanic children across 65 Los Angeles neighborhoods. A series of two-level multilevel models were estimated to examine the independent effects of race, ethnicity, and country of origin on childhood asthma. Lifetime asthma prevalence was reported among 9% of children, with no significant differences between Hispanics and non-Hispanic whites overall. However, in fully adjusted models, Hispanic children of non-Mexican origin reported higher odds of asthma compared to non-Hispanic white children. A protective nativity effect was also observed among children of foreign born mothers compared to US born mothers. Our study provides evidence in support of the heterogeneity of childhood asthma by Hispanic ethnicity and maternal nativity. These findings suggest moving beyond solely considering racial/ethnic classifications which could mask subgroups at increased risk of childhood asthma.

Figure 1. Odds ratios and 95% confidence intervals for lifetime asthma diagnosis among LA FANS children by race/ethnicity

Note: The results reflect adjustment for children’s age, gender, health insurance status, primary caregiver’s education, receipt of public assistance, current smoking status, maternal asthma history, and maternal and child nativity.

Figure 2. Odds ratios and 95% confidence intervals for lifetime asthma diagnosis among LA FANS children by maternal and child nativity

Note: The results reflect adjustment for children’s age, gender, health insurance status, primary caregiver’s education, receipt of public assistance, current smoking status, maternal asthma history, and ethnicity.