Do Ethnicity & Acculturation Matter in Latino Children's Asthma Health Disparities?

Background: The factors leading to asthma health disparities between Mexican and Puerto Rican (PR) children are complex, yet little research integrating the multiple factors leading to these disparities has been conducted. Because parents ultimately make final treatment decisions for their children, it is parents' representation of children's illness that influences those decisions and children's asthma outcomes. These analyses examined the influence of ethnicity, acculturation, symptom perception, and healthcare provider relationship on parents' asthma illness representations (IRs).Methods: 112 Mexican and 54 PR mothers completed baseline interviews in a 1 year, multi-site longitudinal study of a multi-factorial model examining health disparities in childhood asthma. Instruments for these analyses were the Asthma Illness Representation Scale (AIRS), Stephenson Multi-Cultural Acculturation Scale, and Pediatric Asthma Symptom Checklist. Instruments were available in English and Spanish. Results: Forty percent of variance in AIRS scores was accounted for. Mexican mothers reported IRs with the professional model of asthma management more than PR mothers (t=1.89, p=.06). Better healthcare provider relationship (t=8.69, p<.0001) and higher dominant culture immersion (t=2.76, p<.006) were associated with professional model IRs. Higher panic about child's symptoms was associated with lay model IRs (t=-2.41, p=.02). A significant ethnicity x acculturation effect was observed (t=2.19, p=.03); with PR ethnicity and higher acculturation associated with lay model IRs.Conclusions: Results may partially explain why PR children have worse asthma health outcomes than Mexican children. Higher acculturation and panic in PR mothers led to lay model IRs associated with less controller medication use and worse child health outcomes.