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Pediatric Asthma Health Disparities: Race, Hardship, Housing, and Asthma in a National Survey

Abstract Objective We sought to determine if racial disparities in pediatric asthma are explained by material hardship and home ownership. Methods We performed a secondary analysis of the 2011 American Housing Survey. A total of 33,201 households with children age 6 to 17 years were surveyed regardi... Full description

Journal Title: Academic pediatrics 2016, Vol.17 (2), p.127-134
Main Author: Hughes, Helen K., MD, MPH
Other Authors: Matsui, Elizabeth C., MD, MHS , Tschudy, Megan M., MD, MPH , Pollack, Craig E., MD, MHS , Keet, Corinne A., MD, PhD
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: United States: Elsevier Inc
ID: ISSN: 1876-2859
Link: https://www.ncbi.nlm.nih.gov/pubmed/27876585
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recordid: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5337434
title: Pediatric Asthma Health Disparities: Race, Hardship, Housing, and Asthma in a National Survey
format: Article
creator:
  • Hughes, Helen K., MD, MPH
  • Matsui, Elizabeth C., MD, MHS
  • Tschudy, Megan M., MD, MPH
  • Pollack, Craig E., MD, MHS
  • Keet, Corinne A., MD, PhD
subjects:
  • Adolescent
  • Adult
  • African Americans - statistics & numerical data
  • Aged
  • Article
  • Asian Americans - statistics & numerical data
  • Asthma
  • Asthma - epidemiology
  • Asthma in children
  • Child
  • Children
  • Discrimination in medical care
  • Educational Status
  • Emergency Service, Hospital - utilization
  • Ethnic Groups - statistics & numerical data
  • European Continental Ancestry Group - statistics & numerical data
  • Family Characteristics
  • Female
  • Health aspects
  • Health care disparities
  • Health Status Disparities
  • Healthcare Disparities
  • Hispanic Americans - statistics & numerical data
  • Housing
  • Housing - statistics & numerical data
  • Humans
  • Income - statistics & numerical data
  • Logistic Models
  • Male
  • Medical care
  • Medical colleges
  • Middle Aged
  • Neonatal and Perinatal Medicine
  • Odds Ratio
  • Ownership - statistics & numerical data
  • Pediatrics
  • Poverty
  • Public opinion
  • Quality management
  • Surveys
  • United States
  • Young Adult
ispartof: Academic pediatrics, 2016, Vol.17 (2), p.127-134
description: Abstract Objective We sought to determine if racial disparities in pediatric asthma are explained by material hardship and home ownership. Methods We performed a secondary analysis of the 2011 American Housing Survey. A total of 33,201 households with children age 6 to 17 years were surveyed regarding childhood asthma diagnosis and emergency department (ED) visits for asthma (for the youngest child with asthma in the household). Material hardship included poor housing quality, housing crowding, lack of amenities, and no vehicle access. We used logistic regression to determine the association between race, material hardship, and asthma diagnosis or ED visits, adjusting for potential confounders. Results Non-Hispanic black heads of household had a higher odds of having a child diagnosed with asthma in the home compared with non-Hispanic white heads of household (odds ratio, 1.72; 95% confidence interval [CI], 1.50–1.96), and a higher odds of ED visits for asthma (odds ratio, 3.02; 95% CI, 2.29–3.99). The race–asthma association was decreased but not eliminated after adjusting for material hardship and home ownership (ED visit adjusted odds ratio [AOR], 2.07; 95% CI, 1.50–2.86). Poor housing quality was independently associated with asthma diagnosis (AOR, 1.45; 95% CI, 1.28–1.66) and ED visits (AOR, 1.59; 95% CI, 1.21–2.10). Home ownership was associated with a lower odds of asthma-related ED visits (AOR, 0.62; 95% CI, 0.46–0.84). Conclusions Observed racial disparities in pediatric asthma are lessened after controlling for material hardship. Poor housing quality in particular is strongly associated with asthma morbidity. Policy makers could target improving housing quality as a means of potentially reducing asthma disparities.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 1876-2859
fulltext: fulltext
issn:
  • 1876-2859
  • 1876-2867
url: Link


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creatorcontribHughes, Helen K., MD, MPH ; Matsui, Elizabeth C., MD, MHS ; Tschudy, Megan M., MD, MPH ; Pollack, Craig E., MD, MHS ; Keet, Corinne A., MD, PhD
descriptionAbstract Objective We sought to determine if racial disparities in pediatric asthma are explained by material hardship and home ownership. Methods We performed a secondary analysis of the 2011 American Housing Survey. A total of 33,201 households with children age 6 to 17 years were surveyed regarding childhood asthma diagnosis and emergency department (ED) visits for asthma (for the youngest child with asthma in the household). Material hardship included poor housing quality, housing crowding, lack of amenities, and no vehicle access. We used logistic regression to determine the association between race, material hardship, and asthma diagnosis or ED visits, adjusting for potential confounders. Results Non-Hispanic black heads of household had a higher odds of having a child diagnosed with asthma in the home compared with non-Hispanic white heads of household (odds ratio, 1.72; 95% confidence interval [CI], 1.50–1.96), and a higher odds of ED visits for asthma (odds ratio, 3.02; 95% CI, 2.29–3.99). The race–asthma association was decreased but not eliminated after adjusting for material hardship and home ownership (ED visit adjusted odds ratio [AOR], 2.07; 95% CI, 1.50–2.86). Poor housing quality was independently associated with asthma diagnosis (AOR, 1.45; 95% CI, 1.28–1.66) and ED visits (AOR, 1.59; 95% CI, 1.21–2.10). Home ownership was associated with a lower odds of asthma-related ED visits (AOR, 0.62; 95% CI, 0.46–0.84). Conclusions Observed racial disparities in pediatric asthma are lessened after controlling for material hardship. Poor housing quality in particular is strongly associated with asthma morbidity. Policy makers could target improving housing quality as a means of potentially reducing asthma disparities.
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1Matsui, Elizabeth C., MD, MHS
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4Keet, Corinne A., MD, PhD
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descriptionAbstract Objective We sought to determine if racial disparities in pediatric asthma are explained by material hardship and home ownership. Methods We performed a secondary analysis of the 2011 American Housing Survey. A total of 33,201 households with children age 6 to 17 years were surveyed regarding childhood asthma diagnosis and emergency department (ED) visits for asthma (for the youngest child with asthma in the household). Material hardship included poor housing quality, housing crowding, lack of amenities, and no vehicle access. We used logistic regression to determine the association between race, material hardship, and asthma diagnosis or ED visits, adjusting for potential confounders. Results Non-Hispanic black heads of household had a higher odds of having a child diagnosed with asthma in the home compared with non-Hispanic white heads of household (odds ratio, 1.72; 95% confidence interval [CI], 1.50–1.96), and a higher odds of ED visits for asthma (odds ratio, 3.02; 95% CI, 2.29–3.99). The race–asthma association was decreased but not eliminated after adjusting for material hardship and home ownership (ED visit adjusted odds ratio [AOR], 2.07; 95% CI, 1.50–2.86). Poor housing quality was independently associated with asthma diagnosis (AOR, 1.45; 95% CI, 1.28–1.66) and ED visits (AOR, 1.59; 95% CI, 1.21–2.10). Home ownership was associated with a lower odds of asthma-related ED visits (AOR, 0.62; 95% CI, 0.46–0.84). Conclusions Observed racial disparities in pediatric asthma are lessened after controlling for material hardship. Poor housing quality in particular is strongly associated with asthma morbidity. Policy makers could target improving housing quality as a means of potentially reducing asthma disparities.
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1Adult
2African Americans - statistics & numerical data
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5Asian Americans - statistics & numerical data
6Asthma
7Asthma - epidemiology
8Asthma in children
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15European Continental Ancestry Group - statistics & numerical data
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26Income - statistics & numerical data
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32Neonatal and Perinatal Medicine
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34Ownership - statistics & numerical data
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36Poverty
37Public opinion
38Quality management
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41Young Adult
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titlePediatric Asthma Health Disparities: Race, Hardship, Housing, and Asthma in a National Survey
authorHughes, Helen K., MD, MPH ; Matsui, Elizabeth C., MD, MHS ; Tschudy, Megan M., MD, MPH ; Pollack, Craig E., MD, MHS ; Keet, Corinne A., MD, PhD
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1Adult
2African Americans - statistics & numerical data
3Aged
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5Asian Americans - statistics & numerical data
6Asthma
7Asthma - epidemiology
8Asthma in children
9Child
10Children
11Discrimination in medical care
12Educational Status
13Emergency Service, Hospital - utilization
14Ethnic Groups - statistics & numerical data
15European Continental Ancestry Group - statistics & numerical data
16Family Characteristics
17Female
18Health aspects
19Health care disparities
20Health Status Disparities
21Healthcare Disparities
22Hispanic Americans - statistics & numerical data
23Housing
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25Humans
26Income - statistics & numerical data
27Logistic Models
28Male
29Medical care
30Medical colleges
31Middle Aged
32Neonatal and Perinatal Medicine
33Odds Ratio
34Ownership - statistics & numerical data
35Pediatrics
36Poverty
37Public opinion
38Quality management
39Surveys
40United States
41Young Adult
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0Hughes, Helen K., MD, MPH
1Matsui, Elizabeth C., MD, MHS
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atitlePediatric Asthma Health Disparities: Race, Hardship, Housing, and Asthma in a National Survey
jtitleAcademic pediatrics
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date2016
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issn1876-2859
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notes
0Craig E Pollack: 2024 Bldg Suite 2600, 600 N Wolfe St, Baltimore, MD 21287 cpollac2@jhmi.edu
1Corinne A Keet: CMSC 1102, 600 N Wolfe St, Baltimore, MD 21287 ckeet1@jhmi.edu
2Megan M Tschudy: Rubenstein Child Health Bldg 2015, 200 N Wolfe St, Baltimore, MD 21287 mtschud1@jhmi.edu
3Elizabeth C Matsui: CMSC 1102 Pediatrics, 600 N Wolfe St Baltimore, MD 21287. ematsui@jhmi.edu
4Additional contact information
abstractAbstract Objective We sought to determine if racial disparities in pediatric asthma are explained by material hardship and home ownership. Methods We performed a secondary analysis of the 2011 American Housing Survey. A total of 33,201 households with children age 6 to 17 years were surveyed regarding childhood asthma diagnosis and emergency department (ED) visits for asthma (for the youngest child with asthma in the household). Material hardship included poor housing quality, housing crowding, lack of amenities, and no vehicle access. We used logistic regression to determine the association between race, material hardship, and asthma diagnosis or ED visits, adjusting for potential confounders. Results Non-Hispanic black heads of household had a higher odds of having a child diagnosed with asthma in the home compared with non-Hispanic white heads of household (odds ratio, 1.72; 95% confidence interval [CI], 1.50–1.96), and a higher odds of ED visits for asthma (odds ratio, 3.02; 95% CI, 2.29–3.99). The race–asthma association was decreased but not eliminated after adjusting for material hardship and home ownership (ED visit adjusted odds ratio [AOR], 2.07; 95% CI, 1.50–2.86). Poor housing quality was independently associated with asthma diagnosis (AOR, 1.45; 95% CI, 1.28–1.66) and ED visits (AOR, 1.59; 95% CI, 1.21–2.10). Home ownership was associated with a lower odds of asthma-related ED visits (AOR, 0.62; 95% CI, 0.46–0.84). Conclusions Observed racial disparities in pediatric asthma are lessened after controlling for material hardship. Poor housing quality in particular is strongly associated with asthma morbidity. Policy makers could target improving housing quality as a means of potentially reducing asthma disparities.
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pmid27876585
doi10.1016/j.acap.2016.11.011
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