Minority Health

Some Latino children are more likely to have asthma than others

Asthma is the most common chronic illness affecting Latino children, but Puerto Rican children are affected the most (11.5 percent vs. 5.2 percent of Cuban American children and 2.7 percent of Mexican American children). This is probably due to a combination of unique genetic and sociocultural factors, according to a recent review of the literature. For instance, Puerto Rican children have a smaller airway size, more severe inflammatory reactions, and lower birthweight than Cuban American or Mexican American children.

The inflammatory reaction and resulting airway constriction that are typical of asthma usually are sparked by exposure to indoor allergens or irritants such as cockroaches, pets, mold, and smoke, as well as outdoor ones like pollen and pollution. These exposures, along with respiratory infections, have been implicated in the development and worsening of asthma. Puerto Rican mothers, especially teenage mothers, have a much higher rate of smoking than Cuban American or Mexican American mothers.

Also, Puerto Rican families sometimes treat asthma with folk or home remedies unlike Mexican American families, who are more likely to treat asthma with conventional medicines. Several previous studies have suggested that family structure and a child's physical and social environment may play a role in the development and severity of asthma. For example, mainland Puerto Ricans (those not living on the island) have the highest proportion of households led by a single mother. What's more, Puerto Ricans and Mexican Americans are less educated and have less family income than Cuban Americans. Finally, the presence and importance of extended family support structures among Mexican Americans and the emphasis placed on higher education by Cuban Americans may enable these groups to better cope with and manage this multifactorial disease, conclude the researchers who conducted the review. Their work was supported in part by the Agency for Health Care Policy and Research (National Research Service Award training grant T32 HS00007).

See "Elevated asthma morbidity in Puerto Rican children: A review of possible risk and prognostic factors," by Marielena Lara, M.D., M.P.H., Hal Morgenstern, Ph.D., Naihua Duan, Ph.D., and Robert H. Brook, M.D., in the February 1999 Western Journal of Medicine 170, pp. 75-84.

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