Pediatric Asthma Among Small Racial/Ethnic Minority Groups: An Analysis of the 2006-2015 National Health Interview Survey

Wen, Chi Pang; Liu, Shelley H.; Li, Yan; Sheffield, Perry; Liu, Bian

doi:10.1177/0033354919849943

Cited by 17 publications

(9 citation statements)

References 13 publications

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“…The higher rates among children in California compared to the United States as a whole [ 2 ] may reflect higher actual prevalence or suggest that perhaps better assessment and screening of asthma at the national level is necessary. The finding of higher asthma prevalence among boys and African Americans is also consistent with national data [ 2 ], as is the higher prevalence of those with two or more races [ 3 ]. California, due to its SCHIP (State Children’s Health Insurance Plan) which is primarily targeted towards immigrant minorities, could be one the reason for better diagnosis compared to national numbers [ 40 ].…”

Section: Discussionsupporting

confidence: 84%

“…Asthma is a leading chronic disease among children in the United States [ 1 ], with prevalence being higher among boys (9.2 %) than among girls (7.4 %) [ 2 ]. Prevalence is higher among minorities [ 3 ], particularly among non-Hispanic African American/Black children (15.7 %) compared to white children (7.1 %) [ 2 ]. Uncontrolled asthma symptoms can lead to serious complications ranging from sleep disturbance [ 4 ] to death [ 5 ]; thus, the imperative to address determinants of asthma burden among children [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Socio-demographics and asthma prevalence, management, and outcomes among children 1–11 years of age in California

Banta

Ramadan

Alhusseini

et al. 2021

glob health res policy

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Background Asthma disproportionately affects minority and low-income children. We examined asthma prevalence, management and outcomes, focusing on race/ethnicity and acculturation of parents (particularly English language proficiency). Methods This cross-sectional, correlational analysis used a de-identified population-based survey, the California Health Interview Survey, for years 2001–2015. Survey-weighted analysis with SAS 9.4 was used to determine asthma prevalence among children 1 to 11 years of age. Descriptive analysis was conducted, adjusting for survey design and combination of multiple years of data. The Pearson test, using design-based F values was used to determine statistically significant differences between those having/not having a doctor diagnosis of asthma. Multivariable logistic regression, with jackknife approach to obtain confidence intervals, was used to examine associations of child and parental characteristics with asthma prevalence, management, and outcomes. Results The 61,625 completed surveys represented an estimated annual population of 5.7 million children, of which 12.9 % had asthma. There were significant (p < 0.001) differences by age, gender, race, and language proficiency, with higher asthma prevalence for children 6 to 11 years of age (15.5 %), males (15.3 %), African Americans (19.5 %), and parents speaking English very well (14.1 %). Compared to children whose parents spoke English very well, those whose parents spoke English not well or not at all were less likely to achieve optimal asthma management, i.e. to have received a management plan from doctor (OR 0.30; 95 % Confidence Interval 0.20–0.46)), to be currently taking medication to control asthma (OR 0.52; 95 % CI 0.36–0.74)), or to be not confident in ability to control asthma (OR 3.10; 95 % CI 1.49–6.42). Children whose parents spoke English fairly well rather than very well had worse outcomes, i.e. were more likely to have an emergency room visit in past 12 months (OR 1.92; 95 % CI 1.03–3.61) and were more likely to miss school due to asthma in past 12 months (OR 0.71; 1.01–2.94). Conclusions Socio-demographics had a limited role in explaining differences across a handful of asthma management and outcome measures in California. Parental English language proficiency had the most consistent influence, underscoring the need for culturally and linguistically competent care.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Socio-demographics and asthma prevalence, management, and outcomes among children 1–11 years of age in California

Banta

Ramadan

Alhusseini

et al. 2021

glob health res policy

View full text Add to dashboard Cite

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“…Almost all aspects of SEP are differentially distributed by race and ethnicity, including those stressors that we discuss here as primary drivers of SEP-related susceptibility to pollution (e.g., violence, poverty). While disparities exist for many historically marginalized racial and ethnic groups in the U.S., we focus here on the contrast of Black and White populations, but still acknowledge the importance of unpacking the SEP/race relationship for other groups and subgroups, as disproportionate health burdens for other subgroups remains an important gap in the literature [ 43 ]. These racial disparities in stressor exposures stem from both historical practices (e.g., redlining) and modern processes of segregation, which concentrate wealth in White communities, and limit economic advancement for families of color.…”

Section: The Inextricable Relationships Among Sep Race and Susceptibi...mentioning

confidence: 99%

What Is “Socioeconomic Position (SEP),” and How Might It Modify Air Pollution-Health Associations? Cohering Findings, Identifying Challenges, and Disentangling Effects of SEP and Race in US City Settings

Clougherty

Humphrey

Kinnee

et al. 2022

Curr Envir Health Rpt

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Purpose of Review Environmental epidemiology has long considered socioeconomic position (SEP) to be an important confounder of pollution effects on health, given that, in the USA, lower-income and minority communities are often disproportionately exposed to pollution. In recent decades, a growing literature has revealed that lower-SEP communities may also be more susceptible to pollution. Given the vast number of material and psychosocial stressors that vary by SEP, however, it is unclear which specific aspects of SEP may underlie this susceptibility. As environmental epidemiology engages more rigorously with issues of differential susceptibility, it is pertinent to define SEP more clearly, to disentangle its many aspects, and to move towards identifying causal components. Myriad stressors and exposures vary with SEP, with effects accumulating and interacting over the lifecourse. Here, we ask: In the context of environmental epidemiology, how do we meaningfully characterize”SEP”? Recent Findings In answering this question, it is critical to acknowledge that SEP, stressors, and pollution are differentially distributed by race in US cities. These distributions have been shaped by neighborhood sorting and race-based residential segregation rooted in historical policies and processes (e.g., redlining), which have served to concentrate wealth and opportunities for education and employment in predominantly-white communities. As a result, it is now profoundly challenging to separate SEP from race in the urban US setting. Summary Here, we cohere evidence from our recent and on-going studies aimed at disentangling synergistic health effects among SEP-related stressors and pollutants. We consider an array of SEP-linked social stressors, and discuss persistent challenges in this epidemiology, many of which are related to spatial confounding among multiple pollutants and stressors. Combining quantitative results with insights from qualitative data on neighborhood perceptions and stress (including violence and police-community relations), we offer a lens towards unpacking the complex interplay among SEP, community stressors, race, and pollution in US cities.

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“…A limitation of the survey is that it only examined White, Black, or Hispanic, and low-income versus higher-income subpopulations. No analyses within Hispanic subgroups (e.g., Black Hispanic) were conducted, and other subpopulations in the USA that have been shown to be at-risk for poor asthma and eczema outcomes (i.e., American Indian/Alaska Native, maternal smoking) were not evaluated [ 28 , 29 ]. The numbers of Hispanic and participants with low income were relatively low compared with the other subpopulations, which may limit the ability to make effective comparisons.…”

Section: Discussionmentioning

confidence: 99%

Impact of Social Determinants on the Burden of Asthma and Eczema: Results from a US Patient Survey

Bukstein¹,

Friedman

Reyes

et al. 2022

Adv Ther

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Introduction Little is known about how patients with asthma and eczema perceive their medical care and burden of disease. A survey was conducted to evaluate the perceptions among the general patient population with asthma and/or eczema regarding disease and treatment burden and barriers to adequate care. Methods An online survey was completed by market research panelists in the USA between March 24, 2020 and April 6, 2020. Eligible participants were at least 18 years of age and endorsed a diagnosis of asthma and/or eczema. Survey responses are described for all participants, by designated racial/ethnic groups, and by income level. Results In all, 841 participants completed the survey (asthma, n = 554; eczema, n = 398; both, n = 111; White, n = 421; Black, n = 252; Hispanic, n = 95; low income [less than $15,000/year], n = 99; higher income [at least $15,000/year], n = 713). More Black and Hispanic participants than White participants, and more participants with low income than higher income, endorsed health literacy as a barrier (e.g., filling out official documents, understanding written materials). Participants with low income were less likely than participants with higher income to have an asthma action plan (42% vs 53%, respectively) and to discuss asthma control with their healthcare provider (54% vs 69%). Black and Hispanic participants were more likely than White participants to have an emergency department visit (52% and 49% vs 31%, respectively) or hospitalization (31% and 39% vs 16%) for asthma within the last 12 months. Participants reporting low income indicated that they experienced eczema symptoms more frequently than participants with higher income; 35% of low-income participants vs 15% of higher-income participants reported that they had not tried any eczema treatments. Participants in all racial/ethnic and income-level groups reported that their asthma or eczema impacted their lifestyle and daily activities. Conclusion More effective and culturally informed communication and education strategies to improve health information uptake and shared decision-making are needed to reduce the burdens of disease and treatment in highly impacted populations. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-021-02021-0.

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Pediatric Asthma Among Small Racial/Ethnic Minority Groups: An Analysis of the 2006-2015 National Health Interview Survey

Cited by 17 publications

References 13 publications

Socio-demographics and asthma prevalence, management, and outcomes among children 1–11 years of age in California

Socio-demographics and asthma prevalence, management, and outcomes among children 1–11 years of age in California

What Is “Socioeconomic Position (SEP),” and How Might It Modify Air Pollution-Health Associations? Cohering Findings, Identifying Challenges, and Disentangling Effects of SEP and Race in US City Settings

Impact of Social Determinants on the Burden of Asthma and Eczema: Results from a US Patient Survey

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