Race, Socioeconomic Factors, and Area of Residence Are Associated with Asthma Prevalence

Asthma prevalence in the United States has been reported to be higher in minority groups such as Blacks and Hispanics. Because a disproportionate number of individuals from such minority groups are of low socioeconomic status (SES), it is unclear how much of the racial/ethnic differences in asthma prevalence is related to low SES. We investigated the effect of SES on the relationship between race/ethnicity and asthma prevalence in a cohort of families with a history of asthma or allergies from the Boston, Massachusetts area. From 499 families, a cohort of 998 parents and 307 children was identified. We used total yearly family income (<$50,000 vs. > or = $50, 000), highest level of education (< or = high school vs. > or = college), and residence in high-poverty areas vs. low-poverty areas as measures of SES. Yearly family income <$50,000, < or = high school education, and residence in high poverty areas were all associated with increased risks for asthma in both cohorts. In the parental cohort, Blacks and Hispanics (OR = 2.1, 95% CI = 1.5, 2.8; and OR = 2.2, 95% CI = 1.5, 3.2, respectively) were at greater risk for asthma than Whites. In the cohort of children, Black and Hispanic children (OR = 2.9, 95% CI = 1.0, 8.0; and OR = 5.3, 95% CI = 1.6, 17.5, respectively) were also at increased risk for asthma. When the three measures of SES were included in the multivariable models, the risks associated with Blacks and Hispanics decreased in both cohorts: OR = 1.4, 95% CI = 0.9, 2.0; and OR = 1.6, 95% CI = 1.0, 2. 6, respectively, for the parents; and OR = 0.8, 95% CI = 0.2, 3.0; and 2.5, 95% CI = 0.5, 11.7, respectively, for the children. We conclude that a large proportion of the racial/ethnic differences in asthma prevalence in our study is explained by factors related to income, area of residence, and level of education.