Race disparities in childhood asthma: does where you live matter?
Pearlman, D.N.; Zierler, S.; Meersman, S.; Kim, H.K.; Viner-Brown, S.I.; Caron, C.
Journal of the National Medical Association 98(2): 239-247
2006
ISSN/ISBN: 0027-9684 PMID: 16708510 Document Number: 602600
Objective: This study investigates whether racial/ethnic disparities in childhood asthma prevalence can be explained by differences in family and neighborhood socioeconomic position (SEP).Methods: Data were from the 2001 Rhode Island Health Interview Survey (RI HIS), a statewide representative sample of 2,600 Rhode Island households, and the 2000 U.S. Census. A series of weighted multivariate models were fitted using generalized estimating equations (GEE) for the logistic case to analyze the independent and joint effects of race/ethnicity and SEP on doctor-diagnosed asthma among 1,769 white, black and Hispanic children < 18 years old.Results: Compared with white children, black children were at increased odds for asthma and this effect persisted when measures of family and neighborhood SEP were included in multivariate models (AOR: 2.49; 95% Cl: 1.30-4.77). Block children living in poverty neighborhoods had substantially higher odds of asthma than Hispanic and white children in poverty areas and children in moderate- and high-income neighborhoods (AOR: 3,20; 95% Cl: 1.62-6.29).Conclusion: The high prevalence of asthma among black children in poor neighborhoods is consistent with previous research on higher-than-average prevalence of childhood asthma in poor urban minority communities. Changing neighborhood social structures that contribute to racial disparties in asthma prevalence remains a challenge.