Acculturation is associated with asthma burden and pulmonary function in Latino youth: The GALA II study

Neeta Thakur; Luisa N Borrell; Morgan Ye; Sam S Oh; Celeste Eng; Kelley Meade; Pedro C Avila; Harold J Farber; Denise Serebrisky; Emerita Brigino-Buenaventura; William Rodriguez-Cintron; Rajesh Kumar; Kirsten Bibbins-Domingo; Shannon Thyne; Saunak Sen; Jose R Rodriguez-Santana; Esteban G Burchard

doi:10.1016/j.jaci.2018.12.1015

Acculturation is associated with asthma burden and pulmonary function in Latino youth: The GALA II study

J Allergy Clin Immunol. 2019 May;143(5):1914-1922. doi: 10.1016/j.jaci.2018.12.1015. Epub 2019 Jan 22.

Authors

Neeta Thakur¹, Luisa N Borrell², Morgan Ye³, Sam S Oh³, Celeste Eng³, Kelley Meade⁴, Pedro C Avila⁵, Harold J Farber⁶, Denise Serebrisky⁷, Emerita Brigino-Buenaventura⁸, William Rodriguez-Cintron⁹, Rajesh Kumar¹⁰, Kirsten Bibbins-Domingo³, Shannon Thyne¹¹, Saunak Sen¹², Jose R Rodriguez-Santana¹³, Esteban G Burchard¹⁴

Affiliations

¹ Department of Medicine, University of California, San Francisco, Calif. Electronic address: Neeta.Thakur@ucsf.edu.
² Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York, NY.
³ Department of Medicine, University of California, San Francisco, Calif.
⁴ Children's Hospital and Research Center Oakland, Oakland, Calif.
⁵ Allergy ENT & Associates, Woodlands, Tex.
⁶ Department of Pediatrics, Section of Pulmonology, Baylor College of Medicine and Texas Children's Hospital, Houston, Tex.
⁷ Pediatric Pulmonary Division, Jacobi Medical Center, Bronx, NY.
⁸ Department of Allergy and Immunology, Kaiser Permanente-Vallejo Medical Center, Vallejo, Calif.
⁹ Veterans Caribbean Health Care System, San Juan, Puerto Rico.
¹⁰ Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill.
¹¹ Department of Pediatrics, University of California, Los Angeles, Calif.
¹² Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tenn.
¹³ Centro de Neumología Pediátrica, San Juan, Puerto Rico.
¹⁴ Department of Medicine, University of California, San Francisco, Calif; Department of Bioengineering & Therapeutic Sciences, University of California, San Francisco, Calif.

Abstract

Background: Acculturation is an important predictor of asthma in Latino youth, specifically Mexican Americans. Less is known about acculturation and pulmonary function measures.

Objective: We sought to estimate the association of acculturation measures with asthma and pulmonary function in Latino youth and determine whether this association varies across Latino subgroups.

Methods: We included 1849 Latinos (302 Caribbean Spanish, 193 Central or South Americans, 1136 Mexican Americans, and 218 other Latino children) aged 8 to 21 years from 4 urban regions in the United States. Acculturation measures include nativity status, age of immigration, language of preference, and generation in the United States. We used multivariable logistic and linear regression models to quantify the association of acculturation factors with the presence of asthma (case-control study) and pulmonary function (case-only study), adjusting for demographic, socioenvironmental, and clinical variables.

Results: For all acculturation measures (nativity status, age of immigration, language of preference, and generation in the United States), greater levels of acculturation were associated with greater odds of asthma. Among cases, high (English preference) and medium (equal preference for Spanish and English) levels of language acculturation were associated with decreased bronchodilator response compared with low (Spanish preference) levels (P = .009 and .02, respectively). Similarly, high language acculturation was associated with increased FEV₁ compared with low language acculturation (P = .02). There was insufficient evidence of heterogeneity for associations across Latino subgroups.

Conclusions: Acculturation was associated with diagnosed asthma and pulmonary function in Latino children and is an important factor to consider in the management of Latino youth with asthma.

Keywords: Latino; acculturation; asthma; health disparities; pediatric; social determinants of health.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Acculturation*
Adolescent
Adult
Asthma / epidemiology*
Asthma / ethnology*
Asthma / physiopathology
Case-Control Studies
Child
Female
Forced Expiratory Volume
Hispanic or Latino*
Humans
Male
Young Adult

Abstract

Publication types

MeSH terms

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