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

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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.

Original languageEnglish (US)
JournalAcademic Pediatrics
DOIs
StateAccepted/In press - Apr 26 2016

Fingerprint

Asthma
Pediatrics
Health
Hospital Emergency Service
Odds Ratio
Confidence Intervals
Ownership
Surveys and Questionnaires
Crowding
Administrative Personnel
Logistic Models
Morbidity

Keywords

  • Asthma
  • Health care disparities
  • Housing
  • Pediatrics
  • Poverty

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

@article{86cb700d616545c695dba8a108a3ad2f,
title = "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 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.",
keywords = "Asthma, Health care disparities, Housing, Pediatrics, Poverty",
author = "Helen Hughes and Matsui, {Elizabeth C.} and Tschudy, {Megan Marie} and Craig Pollack and Corinne Keet",
year = "2016",
month = "4",
day = "26",
doi = "10.1016/j.acap.2016.11.011",
language = "English (US)",
journal = "Academic Pediatrics",
issn = "1876-2859",
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TY - JOUR

T1 - Pediatric Asthma Health Disparities

T2 - Race, Hardship, Housing, and Asthma in a National Survey

AU - Hughes, Helen

AU - Matsui, Elizabeth C.

AU - Tschudy, Megan Marie

AU - Pollack, Craig

AU - Keet, Corinne

PY - 2016/4/26

Y1 - 2016/4/26

N2 - 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.

AB - 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.

KW - Asthma

KW - Health care disparities

KW - Housing

KW - Pediatrics

KW - Poverty

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DO - 10.1016/j.acap.2016.11.011

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