Racial/Ethnic Disparity, County-Level Poverty, and Comorbid Obesity, Asthma and Depression

Background: Racial/ethnic disparities exist in obesity, asthma and depression rates. In community settings, these conditions often co-occur; however there is a paucity of research on potential racial/ethnic disparities in these comorbidities and how poverty affects their prevalence rates.

Methods: Self-reported data were obtained from the 2006 Behavioral Risk Factor Surveillance System (BRFSS). The Patient Health Questionnaire was used to measure depression; a cut off of 10 or greater was used to measure major depression, which has 88% sensitivity and 88% specificity for diagnosing major depressive disorder. Body mass index (BMI) was calculated using self-reported weight and height. Asthma was measured by self-report. Logistic regression analyses were performed with adjustment for survey design and controlling for age, gender and smoking status.

Results: Non-Hispanic Blacks were at greater risk for the obesity and asthma comorbidity (odds ratio [95% confidence intervals] = 2.69 [2.35-3.07]); non-Hispanic Blacks, Hispanics, and non-Hispanic Others were at greater risk for the obesity and depression comorbidity (2.84 [2.42-3.32]; 1.74 [1.42-2.14]; 1.25 [1.01-1.54], respectively); non-Hispanic Others were at greater risk for the asthma and depression comorbidity (1.89 [1.38-2.58]). Furthermore, the percentage of persons living in poverty in the county was significantly related with all three comorbid conditions, with range of OR = 1.29-1.69.

Conclusions: Comorbidity between obesity, asthma and depression is more apparent for racial/ethnic minorities and with county-level poverty.