Elevated asthma morbidity in Puerto Rican children: A review of possible risk and prognostic factors

Latino children represent a significant proportion of all US children, and asthma is the most common chronic illness affecting them. Previous research has revealed surprising differences in health among Latino children with a sthma of varying countries of family origin. For instance, Puerto Rican chi ldren have a higher prevalence of asthma than Mexican American or Cuban Ame rican children. In addition, there are important differences in family stru cture and socioeconomic status among these Latino populations: Cuban Americ ans have higher levels of education and family income than Mexican-American s and Puerto Ricans; mainland Puerto Rican children have the highest propor tion of households led by a single mother. Our review of past research docu ments differences in asthma outcomes among Latino children and identifies t he possible genetic, environmental, and health care factors associated with these differences. Based on this review, we propose research studies desig ned to differentiate between mutable and immutable risk and prognostic fact ors. Mle also propose that the sociocultural milieus of Latino subgroups of different ethnic and geographic origin are associated with varying pattern s of risk factors that in turn lead to different morbidity patterns. Our an alysis provides a blueprint for future research, policy development, and th e evaluation of multifactorial interventions involving the collaboration of multiple social sectors, such as health care, public health, education, an d public and private agencies.