Cultural-related, contextual, and asthma-specific risks associated with asthma morbidity in urban children

Daphne Koinis-Mitchell, Elizabeth L McQuaid, Sheryl J Kopel, Cynthia A Esteban, Alexander N Ortega, Ronald Seifer, Cynthia Garcia-Coll, Robert Klein, Elizabeth Cespedes, Glorisa Canino, Gregory K Fritz, Daphne Koinis-Mitchell, Elizabeth L McQuaid, Sheryl J Kopel, Cynthia A Esteban, Alexander N Ortega, Ronald Seifer, Cynthia Garcia-Coll, Robert Klein, Elizabeth Cespedes, Glorisa Canino, Gregory K Fritz

Abstract

The objective of this study was to examine associations between specific dimensions of the multi-dimensional cumulative risk index (CRI) and asthma morbidity in urban, school-aged children from African American, Latino and Non-Latino White backgrounds. An additional goal of the study was to identify the proportion of families that qualify for high-risk status on each dimension of the CRI by ethnic group. A total of 264 children with asthma, ages 7-15 (40% female; 76% ethnic minority) and their primary caregivers completed interview-based questionnaires assessing cultural, contextual, and asthma-specific risks that can impact asthma morbidity. Higher levels of asthma-related risks were associated with more functional morbidity for all groups of children, despite ethnic group background. Contextual and cultural risk dimensions contributed to more morbidity for African-American and Latino children. Analyses by Latino ethnic subgroup revealed that contextual and cultural risks are significantly related to more functional morbidity for Puerto Rican children compared to Dominican children. Findings suggest which type of risks may more meaningfully contribute to variations in asthma morbidity for children from specific ethnic groups. These results can inform culturally sensitive clinical interventions for urban children with asthma whose health outcomes lag far behind their non-Latino White counterparts.