Elevated Asthma Morbidity in Puerto Rican Children

A Review of Possible Risk and Prognostic Factors

Published in: Western Journal of Medicine, v. 170, no. 4, Feb. 1999, p. 75-84

Posted on RAND.org on December 31, 1998

by Marielena Lara, Hal Morgenstern, Naihua Duan, Robert H. Brook

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Latino children represent a significant proportion of all U.S. children, and asthma is the most common chronic illness affecting them. Previous research has revealed surprising differences in health among Latino children with asthma of varying countries of family origin. For instance, Puerto Rican children have a higher prevalence of asthma than Mexican American or Cuban American children. In addition, there are important differences in family structure and socioeconomic status among these Latino populations: Cuban Americans have higher levels of education and family income than Mexican-Americans and Puerto Ricans; mainland Puerto Rican children have the highest proportion of households led by a single mother. A review of past research documents differences in asthma outcomes among Latino children and identifies the possible genetic, environmental, and health care factors associated with these differences. Based on this review, the authors propose research studies designed to differentiate between mutable and immutable risk and prognostic factors. They also propose that the sociocultural milieus of Latino subgroups of different ethnic and geographic origin are associated with varying patterns of risk factors that in turn lead to different morbidity patterns. Their analysis provides a blueprint for future research, policy development, and the evaluation of multifactorial interventions involving the collaboration of multiple social sectors, such as health care, publish health, education, and public and private agencies.

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