Dr. Luisa Borrell, professor at the CUNY Graduate School of Public Health and Health Policy, and colleagues examined self-reported racial/ethnic discrimination and bronchodilator response in African American youth with asthma. The findings were published in the journal PLoS One.
[Photo: Dr. Luisa Borrell]
Despite asthma prevalence variation according to sex over the life course, African Americans have one of the highest asthma prevalence and mortality rates in the U.S. The research team examined the association between self-reported racial/ethnic discrimination and bronchodilator response (BDR) among African American youth with asthma ages eight to 21 years (n = 576) and whether this association varied with tumor necrosis factor alpha (TNF-α) level.
Participants for this study were enrolled through the Study of African Americans, Asthma, Genes & Environments (SAGE II) between 2008 and 2014. Participants were African American youth with and without asthma aged 8–21 years of age from the San Francisco Bay Area. The research team used a modified Experiences of Discrimination questionnaire to assess racial/ethnic discrimination, dichotomized as none or any. Biomarkers were measured in stored frozen plasma. The team classified individuals as TNF-α high and low based on being above or below their study population mean.
Almost half of participants (48.8 percent) reported racial/ethnic discrimination. The mean percent bronchodilator response was higher among participants reporting racial/ethnic discrimination than among those who did not. After adjustment, participants reporting racial/ethnic discrimination had a higher bronchodilator response than those not reporting racial/ethnic discrimination. However, the research team found heterogeneity of this association according to TNF-α levels.
The research team concluded that bronchodilator response to be increased in participants reporting racial/ethnic discrimination and this association was limited to African American youth with TNF-α high asthma, an endotype thought to be resistant to traditional asthma medications. These results support screening for racial/ethnic discrimination in those with asthma as it may reclassify disease pathogenesis.Biostatistics and Informatics, CUNY, Environmental Health, Minority Health and Health Disparities