Socioeconomic status and asthma control in African American youth in SAGE II

Abstract

Objective African Americans are disproportionately burdened by asthma. We assessed the individual and joint contribution of socioeconomic status (SES) on asthma morbidity among African American youth. Methods We examined 686 African Americans (8–21 years) with asthma. To account for the joint effects of SES, a composite index was derived from maternal educational attainment, household income, and insurance status. Ordinal logistic regression was used to estimate the individual and joint effect of SES on asthma control. Models were adjusted for age, sex, controller medication use, in utero smoke exposure, family history of asthma, family history of rhinitis, breastfeeding, daycare attendance, and mold exposure. Results Participants were classified as Poorly Controlled Asthma (40.8%), Partially Controlled Asthma (29.7%), or Controlled Asthma (30.2%). Of the individual SES indicators, low income was the strongest predictor of poor asthma control. Children with low income had worse asthma control than those with higher income (OR 1.39; 95%CI 0.92–2.12). The SES index ranged from 4–9. SES was associated with 17% increased odds of poor asthma control with each decrease in the index (95%CI 1.05–1.32). The SES index was associated with asthma-related symptoms, nocturnal awakenings, limited activity, and missed school days. Conclusions The negative effects of SES were observed along the entire socioeconomic gradient, and the adverse asthma outcomes observed in African American youth were not limited to the very poor. We also found that the SES index may be a more consistent and useful predictor of poor asthma outcomes than each indicator alone.

Beck Depression Inventory-II: Factor Analyses with Three Groups of Midlife Women of African Descent in the Midwest, the South, and the U.S. Virgin Islands

“…The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) (Whatley, Allen, & Dana, 2003), other researchers (Joe, Woolley, Brown, Ghahramanlou-Holloway, & Beck, 2008), and the American Psychological Association’s Code of Conduct (American Psychological Association, 2017) have illuminated these concerns. Women of African descent are overrepresented in the lower socioeconomic groups, and it might be hypothesized that stress in their daily lives could help to create depressive symptoms and other physical conditions such as obesity, hypertension, and cardiovascular disease (Senteio & Veinot, 2014; Thakur et al, 2014). Access to quality health care is not easily attained, and health insurance might be limited or unavailable (Miller, Kirk, Kaiser, & Glos, 2014; Thakur et al, 2014).…”

“…Women of African descent are overrepresented in the lower socioeconomic groups, and it might be hypothesized that stress in their daily lives could help to create depressive symptoms and other physical conditions such as obesity, hypertension, and cardiovascular disease (Senteio & Veinot, 2014; Thakur et al, 2014). Access to quality health care is not easily attained, and health insurance might be limited or unavailable (Miller, Kirk, Kaiser, & Glos, 2014; Thakur et al, 2014). Issues that are related to health literacy (Coughlin, Matthews-Juarez, Juarez, Melton, & King, 2014; Guo et al, 2014; James, Harville, Efunbumi, & Martin, 2014; Song et al, 2014) and cultural relevance (Coughlin et al, 2014; Craig et al, 2014) during the clinical encounter and decision-making processes (Smedley, Stith, & Nelson, 2003; United States Department of Health and Human Services Mental Health-The Office of Minority Health, 2016) might also be compromised.…”

HLA-DRB1454 and predictors of new-onset asthma in HIV-infected Thai children

“…Low household income and HLADRB1454 were also predictive of asthma. Low income status was associated with poor asthma control in African American youths [8]. In HIV-infected US children, HLA-A68 was associated with asthmatic medication use while HLA-Cw6 was a preventive factor [9].…”

“…inhaled budesonide, unspecified oral/inhaled bronchodilator, and salbutamol + budesonide) (12.5%). Median (IQR) durations of medications use were 16 (10-41) days for salbutamol, 7 [5][6][7][8] days for terbutaline, 167 (34-427) days for budesonide, and 5 [2][3][4][5][6] days for bronchodilator with no differences between arms (all p N 0.2).…”

Allergic disorders and socio‐economic status: a study of schoolchildren in an urban area of Makassar, Indonesia

“…Socio-economic status (SES) also can affect allergic disorders, as studied in affluent countries [16][17][18]. However, there are not many studies addressing the pattern of allergic disorders within an urban centre in a developing country where large differences in SES and lifestyle are seen.…”