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APHA Scientific Session and Event Listing

Recorded presentation

Molly Martin, MD¹, Madeleine Shalowitz, MD², Tod Mijanovich, MPA³, Beth Clark-Kauffman, MHS², Elizabeth Perez, BS², and Carolyn Berry, PhD³. (1) Department of Preventive Medicine, Rush University Medical Center, 1700 W Van Buren St, Suite 470, Chicago, IL 60612, 312-942-2540, molly_a_martin@rush.edu, (2) Section for Child and Family Health Studies, Evanston Northwestern Healthcare Research Institute, 1001 University Avenue, Evanston, IL 60201, (3) Center for Health and Public Service Research, New York University, 295 Lafayette Street, 2nd Floor, New York, NY 10012

Objective: Mexican-American children have lower asthma prevalence rates than non-Hispanic White and Black children, despite their disproportionate experience of poverty, low education levels, and lack of health insurance. This study tests if caregiver acculturation can explain these paradoxically low rates of asthma.

Methods: Data were from the Social Factors and the Environment in Pediatric Asthma Study, an observational study of urban pediatric asthma. The Mexican-American sub-sample for this analysis included 113 children with diagnosed asthma, 124 with possible asthma, and 260 without asthma. Dependent variables were diagnosed asthma and total asthma (diagnosed plus possible asthma). Regression models controlled for child insurance and caregiver acculturation, education, marital status, possible depression, life stress, and social support.

Results: Acculturation was highly correlated with diagnosed asthma (p<0.01) and total asthma (p<0.01) in bivariate analyses. In the full multivariate model, only children of long-term immigrant Spanish speaking caregivers showed lower odds of diagnosed asthma (OR 0.48, p=0.05) than children of US born caregivers. Children of recent immigrant Spanish speaking caregivers (OR 0.33, p<0.01) and long-term immigrant Spanish speaking caregivers (OR 0.28, p<0.01) had lower odds of total asthma. Social support did not predict asthma or modify acculturation. Total asthma was less likely in children without insurance (OR 0.49, p=0.05) and more likely in children whose caregivers had possible depression (OR 1.67, p=0.04) and high life stress (OR 1.12, p<0.01).

Conclusions: Caregiver acculturation does matter in asthma prevalence for Mexican-American children. Asthma prevalence is also predicted by caregiver life stress, depression, and child insurance status.

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