文章基本信息

标题：Contribution of Race/Ethnicity and Country of Origin to Variations in Lifetime Reported Asthma: Evidence for a Nativity Advantage
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作者：S. V. Subramanian ; Hee-Jin Jun ; Ichiro Kawachi 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2009
卷号：99
期号：4
页码：690-697
DOI：10.2105/AJPH.2007.128843
语种：English
出版社：American Public Health Association
摘要：Objectives. We assessed the relative contribution of Hispanic ethnicity, country of origin, and nativity to lifetime prevalence of asthma among mothers and children enrolled in the Project on Human Development in Chicago Neighborhoods. Methods. We used multilevel models to analyze data from wave 3 of the Project on Human Development in Chicago Neighborhoods study (2000 to 2001). Mothers reported physician-diagnosed asthma for themselves and their children. Maternal race, ethnicity, country of origin, and nativity were the predictors of interest. Results. We found substantial heterogeneity in lifetime asthma within Hispanic subgroups for mothers and children. Hispanics of non-Mexican origin had greater odds of having asthma than did non-Hispanic Whites; respondents of Mexican origin did not differ from non-Hispanic Whites. Odds of experiencing asthma were more strongly related to nativity than to race, Hispanic ethnicity, or country of origin. Only immigrant Mexicans reported asthma prevalence lower than that of native non-Hispanic Whites. Conclusions. Nativity is a strong predictor of lifetime asthma prevalence, suggesting the importance of potential interactions between genetic susceptibilities and environmental factors in both the native and the host countries. The Hispanic health paradox—the relatively better health of this subgroup of the US population, despite their low socioeconomic status—has received considerable attention.^{1 – 4} Evidence for this paradox has been most consistently observed among Mexicans, suggesting that there may be a Mexican paradox or a nativity paradox.^{2 , 5 – 7} Asthma is one of the health conditions for which a Hispanic paradox has been observed. According to the most recent data, 20 million children and adults in the United States suffer from asthma, with a current prevalence of 7.2%⁸ and with substantial heterogeneity by race/ethnicity. Non-Hispanic Whites and Blacks have a prevalence of 6.9% and 9.2%, respectively, and Hispanics have the lowest prevalence (5.4%).⁸ However, the heterogeneity in current asthma prevalence within subgroups of Hispanics is greater than that between Hispanics and non-Hispanics: Hispanics of Puerto Rican origin have the highest prevalence among all racial/ethnic groups (14.5%), and Hispanics of Mexican origin have the lowest (3.9%).⁸ This pattern has been found among children as well as adults.⁸ This substantial heterogeneity among Hispanics from different backgrounds⁹ challenges the notion of a blanket Hispanic health paradox. Asthma prevalence among Hispanics appears to be affected by maternal nativity or country of origin. Although the issue of nativity is beginning to be considered more systematically in health research,^{10 – 15} studying this heterogeneity more explicitly in epidemiological research about asthma is still needed, and the results may have implications for understanding and reducing asthma disparities.⁹ Our aim, therefore, was to discover whether a Hispanic health advantage in reported asthma exists and to examine the relative importance of Hispanic ethnicity, country of origin, and nativity in determining asthma prevalence.