Perceived Discrimination Associated With Asthma and Related Outcomes in Minority Youth: The GALA II and SAGE II Studies

Abstract

Background: 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.

Methods: 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.

Results: 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).

Conclusions: 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.

Keywords: children; health status disparity; psychosocial stress; race; socioeconomic status.

Figure 1

Adjusted odds and corresponding 95% CIs of having asthma with report of perceived discrimination (any/none) according to racial/ethnic group for participants from the Study of African Americans, Asthma, Genes and Environment II (SAGE II) and Genes-Environments and Admixture in Latino Americans II (GALA II) 2006-2014. Models adjusted for age, sex, current and in utero tobacco exposure, socioeconomic status, study site, mother’s preferred language (Latino models), and child’s Latino subgroup (other Latino model).

Figure 2

Adjusted odds and corresponding 95% CIs of having asthma by severity of reported perceived discrimination in African American children, Study of African Americans, Asthma, Genes and Environment II (SAGE II) 2006-2014. Models adjusted for age, sex, current and in utero tobacco exposure, socioeconomic status, and study site.