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
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Article info
Publication history
Published online: November 19, 2016
Accepted:
November 12,
2016
Received:
April 26,
2016
Footnotes
The authors have no conflicts of interest to disclose.
Identification
Copyright
© 2016 by Academic Pediatric Association
