Health Disparities
Sociocultural stressors and asthma among adults in the Hispanic Community Health Study / Study of Latinos (HCHS/SOL) Juan C. Celedón* Yueh-Ying Han Wei Chen Eric Forno Krista M Perreira Eyal Oren Martha Daviglus Olga Garcia-Bedoya Robert Kaplan Carmen Isasi
Hispanic/Latino adults experience high levels of psychosocial stress; however, little is known about sociocultural stressors and asthma in Hispanic adults.
Cross-sectional study of 4,736 adults aged 18 to 74 years who participated in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study. All participants completed an interview-administered sociocultural assessment within 9 months of their baseline exam. Weighted logistic regression accounting for sampling design was used for the analysis on sociocultural stressors (immigrant stress, racism/discrimination, neighborhood social cohesion and neighborhood problems) and current asthma or asthma symptoms. All models adjusted for age, sex, Hispanic/Latino subgroup, site, birthplace, acculturation, health insurance coverage, body mass index, parental history of asthma, smoking status, pack-years of cigarette smoking, dietary patterns (assessed using the alternative health eating index 2010), and three other sociocultural stressors. A mediation analysis was conducted to estimate the contributions of depressive symptoms and anxiety to the sociocultural stressor–asthma association.
Neighborhood problems were associated with increased odds of current asthma (OR for comparison of 2nd-4th quartiles vs. lowest quartile=1.62 [95% CI=1.06-2.46]) and asthma symptoms (OR for 2nd-4th quartiles vs lowest quartile=1.40 [95% CI=1.03-1.91]). Conversely, neighborhood social cohesion was associated with decreased odds asthma. In a mediation analysis adjusted for the same covariates, depressive symptoms and high anxiety explained 20% and 17%, respectively, of the neighborhood problems–asthma symptoms association.
Among Hispanic adults, neighborhood problems were associated with current asthma symptoms, and depressive symptoms and anxiety partly mediated this association. Clinicians caring for adults with asthma should be aware of potential stressors and comorbidities such as depression and anxiety.