Social Determinants of Health and Allergic Disease Prevalence Among Asian American Children

Austin Le; Vivian Bui; Richie Chu; Anna Chen Arroyo; Meng Chen; Adrian Matias Bacong

doi:10.1007/s40615-024-01918-0

Social Determinants of Health and Allergic Disease Prevalence Among Asian American Children

J Racial Ethn Health Disparities. 2024 Feb 5. doi: 10.1007/s40615-024-01918-0. Online ahead of print.

Authors

Austin Le¹, Vivian Bui², Richie Chu^{3

4}, Anna Chen Arroyo^{5

6}, Meng Chen^{5

6}, Adrian Matias Bacong^{7

8}

Affiliations

¹ Division of Environmental Health Sciences, University of California, Berkeley, School of Public Health, Berkeley, USA.
² Division of Epidemiology, University of California, Berkeley, School of Public Health, Berkeley, USA.
³ Department of Community Health Sciences, University of California, Los Angeles, Fielding School of Public Health, Los Angeles, USA.
⁴ Asian American Studies Department, University of California, Los Angeles, Los Angeles, USA.
⁵ Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
⁶ Center for Asian Health Research and Education, Stanford University School of Medicine, Stanford, 1265 Welch Road, Room X200, Palo Alto, CA, 94305, USA.
⁷ Center for Asian Health Research and Education, Stanford University School of Medicine, Stanford, 1265 Welch Road, Room X200, Palo Alto, CA, 94305, USA. abacong@stanford.edu.
⁸ Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA. abacong@stanford.edu.

PMID: 38315290
DOI: 10.1007/s40615-024-01918-0

Abstract

Background: Although racial and ethnic disparities in allergic diseases have previously been observed, the relationship between social determinants of health (SDoH) and allergic disease prevalence among disaggregated Asian American (AsA) subgroups is poorly understood.

Objective: To examine the association of SDoH with allergic disease prevalence among disaggregated AsA subgroups.

Methods: Using the 2011-2018 National Health Interview Survey, we examined caregiver-reported race and ethnicity, SDoH, and allergic diseases. We compared survey-weighted allergic disease prevalence by AsA subgroup. Subgroup-stratified multivariable logistic regression accounting for age, sex, child/parent nativity, and survey year modeled the association between SDoH and allergic disease prevalence. We provide predicted probabilities of having each allergic disease based on exposure to each SDoH.

Results: We examined data from 5042 non-Hispanic AsA children representing 3,264,768 AsA children. Approximately 25% of all AsA children reported at least one allergic disease, ranging from 20% of Asian Indian children to 30% of Filipino/a children. The number of unfavorable SDoH was lowest among Asian Indian and Chinese children (mean 0.7) and highest among "other Asian" children (mean 1.2). In stratified analyses, financial instability and inaccessible healthcare were associated with greater probability of allergic diseases among some, but not all AsA subgroups. Lower parent education level, food insecurity, and rent/other housing arrangement were associated with lower probability of allergic disease among some AsA children.

Conclusion: There was heterogeneity in the association of SDoH and allergic disease prevalence among AsA children. Further study of SDoH may inform modifiable environmental factors for allergic disease among AsA children.

Keywords: Allergy; Asian American; Asthma; Children; Social determinants of health.