Risk factors for pediatric asthma - Contributions of poverty, race, and urban residence

The Child Health Supplement to the 1988 National Health Interview Survey wa s used to examine parent-reported current asthma among a nationally represe ntative sample of 17,110 children zero to 17 yr of age. Numerous demographi c variables were analyzed for independent associations with asthma using mo dified stepwise logistic regression, with models including specific combina tions of risk factors. Black children had higher rates of asthma than did w hite children in unadjusted analyses, but after controlling for multiple fa ctors, black race was not a significant correlate of asthma (adjusted odds ratio = 0.87, 95% CI = 0.63 to 1.21). Compared with nonurban white children , urban children, both black and white, were at significantly increased ris k of asthma: urban and black (adjusted OR = 1.45, 95% CI = 1.14 to 1.86), u rban and white (adjusted OR = 1.22, 95% CI = 1.01 to 1.48), whereas nonurba n black children were not: nonurban and black (adjusted OR = 1.15, 95% CI = 0.83 to 1.61). Similarly, compared with nonurban, nonpoor children, urban and poor (adjusted OR = 1.44, 950/6 CI = 1.05 to 1.95), urban and nonpoor ( adjusted OR = 1.22, 950/6 CI = 1.004 to 1.48), urban children, both poor an d nonpoor, were at significantly increased risk of asthma, whereas nonurban poor children were not: nonurban and poor (adjusted OR = 1.03, 95% CI = 0. 72 to 1.48). These results suggest that the higher prevalence of asthma amo ng black children is not due to race or to low income per se, and that all children living in an urban setting are at increased risk for asthma.