• Neeta Thakur, Nicolas E Barcelo, Luisa N Borrell, Smriti Singh, Celeste Eng, Adam Davis, Kelley Meade, Michael A LeNoir, Pedro C Avila, Harold J Farber, Denise Serebrisky, Emerita Brigino-Buenaventura, William Rodriguez-Cintron, Shannon Thyne, Jose R Rodriguez-Santana, Saunak Sen, Kirsten Bibbins-Domingo, and Esteban Gonzalez Burchard.
• Department of Medicine, University of California, San Francisco, San Francisco.
• Chest. 2017 Apr 1; 151 (4): 804812804-812.

BackgroundAsthma disproportionately affects minority populations and is associated with psychosocial stress such as racial/ethnic discrimination. We aimed to examine the association of perceived discrimination with asthma and poor asthma control in African American and Latino youth.MethodsWe included African American (n = 954), Mexican American (n = 1,086), other Latino (n = 522), and Puerto Rican Islander (n = 1,025) youth aged 8 to 21 years from the Genes-Environments and Admixture in Latino Americans study and the Study of African Americans, Asthma, Genes, and Environments. Asthma was defined by physician diagnosis, and asthma control was defined based on the National Heart, Lung, and Blood Institute guidelines. Perceived racial/ethnic discrimination was assessed by the Experiences of Discrimination questionnaire, with a focus on school, medical, and public settings. We examined the associations of perceived discrimination with each outcome and whether socioeconomic status (SES) and global African ancestry modified these associations.ResultsAfrican American children reporting any discrimination had a 78% greater odds of experiencing asthma (OR, 1.78; 95% CI, 1.33-2.39) than did those not reporting discrimination. Similarly, African American children faced increased odds of poor asthma control with any experience of discrimination (OR, 1.97; 95% CI, 1.42-2.76) over their counterparts not reporting discrimination. These associations were not observed among Latino children. We observed heterogeneity of the association between reports of discrimination and asthma according to SES, with reports of discrimination increasing the odds of having asthma among low-SES Mexican American youth (interaction P = .01) and among high-SES other Latino youth (interaction P = .04).ConclusionsPerceived discrimination is associated with increased odds of asthma and poorer control among African American youth. SES exacerbates the effect of perceived discrimination on having asthma among Mexican American and other Latino youth.Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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