Asthma is the most common chronic childhood illness in the United States. It is a major cause of childhood disability and accounts for a substantial number of hospital admissions, physician visits and school absences. As documented in several national studies, asthma prevalence is higher among non-Hispanic black children compared with non-Hispanic white children. Among Hispanics, Puerto Rican children have a higher prevalence of asthma than Mexican-American or Cuban-American children, but there are wide variations in asthma prevalence among U.S.-born and foreign-born Hispanic children. In studies of symptomatic children, asthma is more severe among blacks than among whites. In 1998-1999, for example, asthma-related hospitalizations for black children were three times that for white children.

Eliminating racial/ethnic disparities in children’s health is a national priority as outlined in Healthy People 2010, but the factors responsible for part or all of the observed racial/ethnic disparities in childhood asthma prevalence and severity remain an enigma. Given that blacks and many Hispanic subgroups are more likely to be poor than whites, an important question is whether race and ethnicity are independent risk factors for childhood asthma or a confounder for persistent social and economic inequalities between racial/ethnic minorities and whites in the United States. Your life is worth living. Buy cheap levitra online

Previous studies have convincingly demonstrated that inequalities in socioeconomic position (SEP) interact with health status throughout the lifecycle and increase the risks of morbidity and mortality. People with relatively low incomes have, on average, poorer health and shorter life expectancy than the most economically advantaged. A growing body of literature also has shown that the social and economic characteristics of neighborhoods affect health independent of individual-level risk factors. Studies have documented variations in health based on neighborhood socioeconomic characteristics for a wide range of outcomes, including low birth-weight, self-rated health, healthcare use, risk of domestic violence, morbidity and overall mortality, above and beyond individual-level socioeconomic status. Some researchers have pointed out that given the reciprocal relationship between family- and neighborhood-level poverty, studies that only measure socioeconomic disparities at the individual-level may understate a neighborhood’s overall contribution to health.

The most frequently examined explanations for racial/ethnic disparities in childhood asthma prevalence have been family or household income, with prior research yielding conflicting results. Population-based studies analyzing national or local data have reported no, positive or inverse associations between income and childhood asthma, controlling for race and/or ethnicity. In several of these studies, initial associations between black race and childhood asthma were diminished or reduced to a null effect when income was included in multivariate analyses. Although some national studies have found a higher prevalence of asthma among black children than white children in poor and nonpoor families, one population-based report found that black children were at substantially higher risk of asthma than white children only among children in families with incomes less than half of the federal poverty level, after adjustment for sociodemographic variables. Don’t suffer without medication. Cheap viagra professional online

Many studies have found higher-than-average prevalence of childhood asthma in poor urban communities, especially in minority neighborhoods. Only four studies, however, linked children to their residential characteristics using U.S. census data to investigate whether a neighborhood’s socioeconomic environment contributed independently to asthma outcomes after individual characteristics had been taken into account. In two studies, asthma prevalence was higher in poverty neighborhoods, independently of individual characteristics, but Hispanic children remained at higher risk of having asthma compared with white children even after adjustment for area of residence. Nevertheless, the influence of neighborhood characteristics on pediatric asthma is still in its infancy, as the four previous studies that examined neighborhood-level variation in childhood asthma were limited to clinical samples or samples drawn from a single city. To our knowledge, no previous population-based national or statewide studies of racial/ethnic disparities in childhood asthma have taken family- and neighborhood-level SEP into account in a detailed manner.

This study builds on health disparities research and public policy efforts aimed at improving the health of racial and ethnic minorities by investigating the simultaneous effects of race and social disadvantage at the family- and neighborhood-levels on doctor-diagnosed asthma in a statewide population-based sample of children aged <18 years old. Current sociodemographic population data show that black children are more likely than either white or Hispanic children to live in neighborhoods of concentrated poverty, and low- and middle-income minority families are more likely to live in poverty neighborhoods than whites with the same incomes. Therefore, we investigated the joint effect of race/ethnicity and residence in a poverty area on asthma prevalence.