Latino and African-American adolescents who live in urban areas were found to be at lower risk for undiagnosed asthma than whites, according to a new study co-authored by Columbia University Mailman School of Public Health doctoral student Ms. Emilie Bruzelius, and Mailman alumna Ms. Katherine. This is the first study to investigate individual- and neighborhood-level factors associated with undiagnosed asthma in a large population of urban adolescents. The findings are published online in the Journal of Urban Health.
Researchers from Columbia University School of Nursing, Columbia Mailman School of Public Health, and Dickinson College analyzed data from 10,295 New York City adolescents who reported on asthma symptoms and diagnosis. A subset of 6,220 adolescents provided addresses which was used to examine neighborhood level factors.
The Latino and African-American adolescents were about one-third less likely to go undiagnosed with asthma, compared with the white students. Also, females were 25 percent more likely to be undiagnosed. Additionally, the researchers found that the risk of having undiagnosed asthma increased in neighborhoods that were highly racially segregated, which may indicate a connection to health care access. Yet, living in a neighborhood that had a shortage of health care providers was associated with a 29 percent lower risk of going undiagnosed.
Known disparities impacting Latino and African-American adolescents might have led health care providers to assess asthma in the two groups more, leading to fewer undiagnosed cases, according to the researchers. Easier access to public transportation in cities also may also play a role, as adolescents can easily travel to other neighborhoods for care.
Overall, symptoms of asthma were reported by slightly more than 20 percent of the teens who were not diagnosed, which was twice that of the adolescents with a diagnosis.
The findings indicate that health care providers who work in lower-income urban areas may want to screen for asthma in adolescents, especially in girls and Asian Americans. Although this study is an important first step, the researchers note that additional sampling will help researchers better understand the relationships.
The research was funded by The National Institutes of Health (R01HL089493) through a grant awarded to the study’s co-lead author, Dr. Jean-Marie Bruzzese, associate professor of applied developmental psychology (in nursing) at Columbia Nursing.