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Journal of Pediatric Psychology Advance Access originally published online on January 11, 2007
Journal of Pediatric Psychology 2007 32(5):582-595; doi:10.1093/jpepsy/jsl050
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© The Author 2007. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Multiple Urban and Asthma-Related Risks and Their Association with Asthma Morbidity in Children

Daphne Koinis-Mitchell, PhD1, Elizabeth L. McQuaid, PhD1, Ronald Seifer, PhD1, Sheryl J. Kopel, MSc1, Cynthia Esteban, MSN, MPH1, Glorisa Canino, PhD2, Cynthia Garcia-Coll, PhD1, Robert Klein, MD1 and Gregory K. Fritz, MD1

1Bradley/Hasbro Children's Research Center, Brown Medical School and 2University of Puerto Rico

All correspondence concerning this article should be addressed to Daphne Koinis-Mitchell, PHD, Child and Family Psychiatry, Bradley/Hasbro Research Center, Brown Medical School, 1 Hoppin Street, Coro West, 2nd Floor, Providence, RI 02903. E-mail: Daphne_Koinis-Mitchell{at}Brown.edu


  Abstract

Objective To determine whether a multi-dimensional cumulative risk index (CRI) is a stronger predictor of asthma morbidity in urban, school-aged children with asthma, than poverty or severity alone. Methods A total of 163 children with asthma, ages 7–15 years (42% female; 69% ethnic minority) and their primary caregivers completed interview-based questionnaires, focusing on potential cultural, contextual, and asthma-specific risks that can impact asthma morbidity. Results Higher levels of cumulative risks were associated with more asthma morbidity, after controlling for poverty level or asthma severity. Analyses by ethnic group and subgroup also supported the relationship between the CRI and specific indices of asthma morbidity. Conclusions This study demonstrates the utility of multiple-dimensional risk models for predicting variations in asthma morbidity in urban children. Research efforts with urban families who have children with asthma need to consider the context of urban poverty as it relates to children's cultural backgrounds and specific asthma outcomes.

Key words: asthma risks; urban.

Received February 1, 2006; revision received July 31, 2006; revision received October 3, 2006; accepted November 25, 2006


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