Rethinking Race/Ethnicity, Income, and Childhood Asthma: Racial/Ethnic Disparities Concentrated among the Very Poor

Smith, Lauren A.; Hatcher-Ross, Juliet L; Wertheimer, Richard; Kahn, Robert S.

doi:10.1177/003335490512000203

Cited by 149 publications

(81 citation statements)

References 60 publications

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“…Our findings add to the growing literature that seeks to understand the nature of disparities in outcomes for chronic health conditions like childhood asthma, including the role of parental factors such as literacy. [28][29][30][31] We found similar effect sizes using literacy or education as the independent variables. In this study, it is hard to know if measuring literacy added more information than we could have obtained by simply asking for years of education completed.…”

Section: Discussionsupporting

confidence: 65%

Low Parental Literacy Is Associated With Worse Asthma Care Measures in Children

DeWalt

Dilling

Rosenthal

et al. 2007

Ambulatory Pediatrics

223

202

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Objective-To determine if parental literacy is related to emergency department visits, hospitalizations, and days of school missed for children with asthma.Methods-We performed a retrospective cohort study at a university pediatric clinic. We enrolled children between 3 and 12 years old with a diagnosis of asthma and a regular source of care at the site of the study and their parent or guardian. Primary asthma care measures included self-reported rates of emergency department visits, hospitalizations, and days of school missed. Secondary asthma care measures included rescue and controller medication use, classification of asthma severity and parental asthma-related knowledge.Results-We enrolled 150 children and their parents. Twenty-four percent of the parents had low literacy. Children of parents with low literacy had greater incidence of emergency department visits (adjusted incidence rate ratio [IRR] 1.5; 95% CI 1.1, 2.1), hospitalizations (IRR 3.2; 1.4, 7.3), and days missed from school (IRR 2.5; 2.1, 3.0) even after adjusting for asthma-related knowledge, disease severity, medication use and other socio-demographic factors. Parents with low literacy had less asthma-related knowledge, and their children were more likely to have moderate or severe persistent asthma and had greater use of rescue medications.Conclusions-Low parental literacy is associated with worse care measures for children with asthma.

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Section: Discussionsupporting

confidence: 65%

Low Parental Literacy Is Associated With Worse Asthma Care Measures in Children

DeWalt

Dilling

Rosenthal

et al. 2007

Ambulatory Pediatrics

223

202

View full text Add to dashboard Cite

show abstract

“…46 National surveys indicate asthma risk is particularly high among children with disadvantages in both racial status and socioeconomic status. 47 Reviews indicate low-income children are more likely to consume polluted air and water, live in lower quality housing, reside in more dangerous neighborhoods, and have poorer quality child care and educational opportunities. 48,49 This study reinforces evidence in its findings that racial/ethnic minorities have more areas of home safety and maintenance concerns than non-Latino white families recruited from the same region.…”

Section: Discussionmentioning

confidence: 99%

Homes of low-income minority families with asthmatic children have increased condition issues

Pacheco

Ciaccio²,

Nazir³

et al. 2014

allergy asthma proc

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“…In previous studies variables such as less parent education and income, living in poorer neighborhoods, and single parent households have been shown to be associated with higher prevalence rates of both asthma [33,34] and of DSM-IV anxiety and depressive disorders [29][30][31]. Youth who are raised in single parent households have also been shown to have a higher risk of externalizing disorders.…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of DSM-IV Anxiety and Depressive Disorders in Youth with Asthma Compared with Controls

Katon

Lozano

Russo

et al. 2007

Journal of Adolescent Health

230

158

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Purpose-To determine the prevalence of anxiety and depressive disorders in youth with asthma compared to a control sample of youth and to determine the sociodemographic and clinical characteristics associated with having ≥1 anxiety/depressive disorders among youth with asthma.Methods-A telephone interview was offered to all youth aged 11 to 17 with asthma (N=781) and a random sample of similar aged controls (N=598) enrolled in a Health Maintenance Organization (HMO). The C-DISC-4.0 was used to diagnose anxiety and depressive disorders and reliable and valid questionnaires were used to assess severity of anxiety and depressive symptoms. Automated diagnostic, pharmacy and health utilization data were used to measure asthma treatment intensity, asthma severity and non-asthmatic medical comorbidity. One parent was interviewed to assess sociodemographic variables, child/adolescent psychiatric symptoms and to confirm the asthma diagnosis.Results-16.3% of youth with asthma compared to 8.6% of youth without asthma met DSM-IV criteria for ≥1 anxiety and depressive disorders (OR = 1.92, 95% CI 1.13-3.28). Independent factors associated with a significantly higher likelihood of meeting criteria for ≥1 anxiety or depressive disorders included female gender [OR = 1.96 (95% CI 1.27, 3.03)], living in a single parent household, [OR = 1.96 (95% CI 1.26, 3.07)], more parent-reported externalizing behaviors [OR = 1.03 (95% CI 1.01, 1.05)], more recent diagnosis of asthma [OR = 0.94 (95% CI 0.89, 0.98)], and more impairment on the asthma physical health scale [OR = 0.95 (95% CI 0.94, 0.96)].Conclusions-Youth with asthma have an almost two-fold higher prevalence of comorbid DSM-IV anxiety and depressive disorders compared to control youth. Clinical factors associated with meeting criteria for ≥1 anxiety and depressive included more recent asthma diagnosis, more impairment on the asthma physical health scale and increased externalizing behaviors. Medicine, 1959 NE Pacific St., Seattle, WA 98195-6560, PH: 206-543-7177, Fax: 206-221-5414, E-Mail: wkaton@u.washington.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Cross-sectional studies have repeatedly found an increased prevalence of panic disorder among youth with asthma. [1][2][3][4][5] A large family history study also recently reported that first degree relatives of patients with panic disorder had a significantly higher prevalence of asthma and chronic obstructive lung disease compared to a control group without panic disorder. NIH Public Access[6] Recent research suggests that youth with asthma also have a high rate of ot...

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Rethinking Race/Ethnicity, Income, and Childhood Asthma: Racial/Ethnic Disparities Concentrated among the Very Poor

Cited by 149 publications

References 60 publications

Low Parental Literacy Is Associated With Worse Asthma Care Measures in Children

Low Parental Literacy Is Associated With Worse Asthma Care Measures in Children

Homes of low-income minority families with asthmatic children have increased condition issues

The Prevalence of DSM-IV Anxiety and Depressive Disorders in Youth with Asthma Compared with Controls

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