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Le A, Bui V, Chu R, Arroyo AC, Chen M, Bacong AM. Social Determinants of Health and Allergic Disease Prevalence Among Asian American Children. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01918-0. [PMID: 38315290 DOI: 10.1007/s40615-024-01918-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/20/2023] [Accepted: 01/20/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Although racial and ethnic disparities in allergic diseases have previously been observed, the relationship between social determinants of health (SDoH) and allergic disease prevalence among disaggregated Asian American (AsA) subgroups is poorly understood. OBJECTIVE To examine the association of SDoH with allergic disease prevalence among disaggregated AsA subgroups. METHODS Using the 2011-2018 National Health Interview Survey, we examined caregiver-reported race and ethnicity, SDoH, and allergic diseases. We compared survey-weighted allergic disease prevalence by AsA subgroup. Subgroup-stratified multivariable logistic regression accounting for age, sex, child/parent nativity, and survey year modeled the association between SDoH and allergic disease prevalence. We provide predicted probabilities of having each allergic disease based on exposure to each SDoH. RESULTS We examined data from 5042 non-Hispanic AsA children representing 3,264,768 AsA children. Approximately 25% of all AsA children reported at least one allergic disease, ranging from 20% of Asian Indian children to 30% of Filipino/a children. The number of unfavorable SDoH was lowest among Asian Indian and Chinese children (mean 0.7) and highest among "other Asian" children (mean 1.2). In stratified analyses, financial instability and inaccessible healthcare were associated with greater probability of allergic diseases among some, but not all AsA subgroups. Lower parent education level, food insecurity, and rent/other housing arrangement were associated with lower probability of allergic disease among some AsA children. CONCLUSION There was heterogeneity in the association of SDoH and allergic disease prevalence among AsA children. Further study of SDoH may inform modifiable environmental factors for allergic disease among AsA children.
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Affiliation(s)
- Austin Le
- Division of Environmental Health Sciences, University of California, Berkeley, School of Public Health, Berkeley, USA
| | - Vivian Bui
- Division of Epidemiology, University of California, Berkeley, School of Public Health, Berkeley, USA
| | - Richie Chu
- Department of Community Health Sciences, University of California, Los Angeles, Fielding School of Public Health, Los Angeles, USA
- Asian American Studies Department, University of California, Los Angeles, Los Angeles, USA
| | - Anna Chen Arroyo
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Center for Asian Health Research and Education, Stanford University School of Medicine, Stanford, 1265 Welch Road, Room X200, Palo Alto, CA, 94305, USA
| | - Meng Chen
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Center for Asian Health Research and Education, Stanford University School of Medicine, Stanford, 1265 Welch Road, Room X200, Palo Alto, CA, 94305, USA
| | - Adrian Matias Bacong
- Center for Asian Health Research and Education, Stanford University School of Medicine, Stanford, 1265 Welch Road, Room X200, Palo Alto, CA, 94305, USA.
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA.
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Arroyo AC, Ko J, Chandra M, Huang P, Darbinian JA, Palaniappan L, Lo JC. Risk of Incident Asthma Among Young Asian American, Native Hawaiian, and Pacific Islander Children from Age 3 to 7 Years in a Northern California Healthcare System. J Pediatr 2024; 265:113802. [PMID: 37898424 DOI: 10.1016/j.jpeds.2023.113802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 10/30/2023]
Abstract
Incident childhood asthma risk has not been examined among diverse Asian American, Native Hawaiian, and Pacific Islander subgroups. In a large California healthcare system, incident asthma was higher among young Filipino/a, Native Hawaiian/Pacific Islander, and South Asian children compared with non-Hispanic White children, whereas Chinese and Japanese children were similar.
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Affiliation(s)
- Anna Chen Arroyo
- Division of Pulmonary, Allergy & Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA; Stanford Center for Asian Health Research and Education, Stanford, CA
| | - Jimmy Ko
- Permanente Medical Group, Department of Allergy, Kaiser Permanente Fremont Medical Center, Fremont, CA
| | - Malini Chandra
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Polly Huang
- Department of Medicine, Kaiser Permanente Oakland Medicine Center, Oakland, CA
| | - Jeanne A Darbinian
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Latha Palaniappan
- Stanford Center for Asian Health Research and Education, Stanford, CA; Division of Cardiovascular Medicine and Division of Epidemiology and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Joan C Lo
- Division of Research, Kaiser Permanente Northern California, Oakland, CA; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA.
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Sethna J, Wong K, Meyers K. Cardiometabolic Health in Asian American Children. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01896-9. [PMID: 38147200 DOI: 10.1007/s40615-023-01896-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/28/2023] [Accepted: 12/11/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND The aim was to compare cardiometabolic health between Asian American children and Non-Hispanic White (NHW) children as well as to compare cardiometabolic health among Asian American children by birthplace. METHODS Children aged 6-17 years enrolled in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018 who self-identified as non-Hispanic Asian and NHW were included. Among Asian Americans, place of birth was defined as foreign born vs United States (US) born. Regression models were adjusted for age, sex, household income, food insecurity, passive smoke exposure, and body mass index (BMI) z-score. RESULTS Among 3369 children, 8.4% identified as Asian American (age 11.7 years) and 91.6% identified as NHW (age 11.7 years). Compared to NHW children, Asian American children had significantly lower BMI z-scores and odds of obesity. Asian American children had higher HOMA-IR, and greater odds of dyslipidemia and microalbuminuria compared to NHW children. Among Asian Americans, 30.5% were foreign born. Compared to foreign-born Asian American children, US-born Asian American children had significantly higher non-HDL, triglycerides, and uric acid, lower HDL, and lower odds of hyperfiltration. There were no differences in blood pressure by racial group or place of birth. CONCLUSIONS Although Asian American children have lower odds of obesity, they have significantly worse glucose intolerance, more dyslipidemia, and more microalbuminuria compared to NHW children. US-born Asian American children have worse cardiometabolic health profiles compared to foreign-born Asian Americans.
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Affiliation(s)
- Julian Sethna
- Division of Pediatric Nephrology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard South 34Th Street, Philadelphia, PA, 19104, USA
| | - Kristal Wong
- Division of Pediatric Nephrology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard South 34Th Street, Philadelphia, PA, 19104, USA.
| | - Kevin Meyers
- Division of Pediatric Nephrology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard South 34Th Street, Philadelphia, PA, 19104, USA.
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Sethna J, Wong K, Meyers K. Cardiometabolic Health in Asian American Children. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.11.23298417. [PMID: 37986922 PMCID: PMC10659473 DOI: 10.1101/2023.11.11.23298417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Background The aim was to compare cardiometabolic health between Asian American children and Non-Hispanic White (NHW) children as well as to compare cardiometabolic health among Asian American children by birthplace. Methods Children aged 6-17 years enrolled in the National Health and Nutrition Examination Survey (NHANES) from 2011-2018 who self-identified as non-Hispanic Asian and NHW were included. Among Asian Americans, place of birth was defined as foreign-born vs United States (US)-born. Regression models were adjusted for age, sex, household income, food insecurity, passive smoke exposure, and body mass index (BMI) z-score. Results Among 3369 children, 8.4% identified as Asian American (age 11.7 years) and 91.6% identified as NHW (age 11.7 years). Compared to NHW children, Asian American children had significantly lower BMI z-scores and odds of obesity. Asian American children had higher HOMA-IR and uric acid, and greater odds of dyslipidemia, microalbuminuria and glomerular hyperfiltration compared to NHW children. Among Asian Americans, 30.5% were foreign-born. Compared to foreign-born Asian American children, US-born Asian American children had significantly higher non-HDL, triglycerides, HOMA-IR and uric acid, lower HDL, and lower odds of hyperfiltration. There were no differences in blood pressure by racial group or place of birth. Conclusions Although Asian American children have lower odds of obesity, they have significantly worse glucose intolerance, higher serum uric acid levels, more dyslipidemia and more microalbuminuria compared to NHW children. US-born Asian American children have worse cardiometabolic health profiles compared to foreign-born Asian Americans.
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Affiliation(s)
- Julian Sethna
- Division of Pediatric Nephrology, Children's Hospital of Philadelphia, Philadelphia PA
| | - Kristal Wong
- Division of Pediatric Nephrology, Children's Hospital of Philadelphia, Philadelphia PA
| | - Kevin Meyers
- Division of Pediatric Nephrology, Children's Hospital of Philadelphia, Philadelphia PA
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