SpringerLink
Log in

Asthmatic Symptoms in Children and Adolescents: the Role of Maternal Experiences of Racial Discrimination

  • Published:
Journal of Racial and Ethnic Health Disparities Aims and scope Submit manuscript

Abstract

Emerging evidence suggests that vicarious racial experiences of discrimination may negatively influence child health. Few studies have focus on childhood asthma symptoms and potential moderators of such relationship.

Methods

We used two population-based cross-sectional studies from the Social Change Allergy and Asthma in Latin America project in Salvador, Brazil. A total of 1003 children and mothers interviewed in 2006 were included, of whom 873 were reached again in 2013. Vicarious racial discrimination was assessed in mothers by applying the Experiences of Discrimination scale. Data on wheeze and environmental exposures were collected with standardized questionnaires. Levels of allergen-specific IgE were measured to identify atopy. Generalized estimating equations were used to estimate the association between maternal discrimination and wheezing and asthma phenotypes. Interaction terms were evaluated to identify whether mothers’ mental health and family social support modified such associations.

Results

Children whose mothers reported racial discrimination had greater odds of have asthma symptoms (OR 1.75; 95% CI 1.15–2.67) and non-atopic asthma (OR 1.92; 95% CI 1.09–3.40). When we considered effect modification by social support, we found a higher ORs when the level of social support was lower (OR 2.43; 95% IC 1.19–4.97) than when the level of social support was higher (OR 1.12; CI 0.64–1.96).

Conclusion

Maternal discrimination was associated with asthma symptoms and with non-atopic phenotype among their children. Enjoying wider social support network appears to buffer the effect on asthmatic symptoms. Intervention on childhood asthma needs to incorporate strategies that target the family.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (France)

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Lai CK, Beasley R, Crane J, et al. Global variation in the prevalence and severity of asthma symptoms: phase three of the International Study of Asthma and Allergies in Childhood (ISAAC). Thorax. 2009;64(6):476–83. https://doi.org/10.1136/thx.2008.106609.

    Article  CAS  PubMed  Google Scholar 

  2. Ribeiro-Silva RC, Malta DC, Rodrigues LC, Ramos D, Fiaccone R, Machado D, et al. Social, environmental and behavioral determinants of asthma symptoms in Brazilian middle school students—a national school health survey (Pense 2012). Int J Environ Res Public Health. 2018;15(12):2904. https://doi.org/10.3390/ijerph1512290.

    Article  PubMed Central  Google Scholar 

  3. Roncada C, de Oliveira SG, Cidade SF, Sarria EE, Mattiello R, Ojeda BS, et al. Burden of asthma among inner-city children from Southern Brazil. J Asthma. 2016;53(5):498–504. https://doi.org/10.3109/02770903.2015.1108438.

    Article  PubMed  Google Scholar 

  4. Barreto ML, Cunha SS, Fiaccone R, et al. Poverty, dirt, infections and non-atopic wheezing in children from a Brazilian urban center. Respir Res. 2010;11(1):167. Published 2010 Dec 1. https://doi.org/10.1186/1465-9921-11-167.

    Article  PubMed  PubMed Central  Google Scholar 

  5. DePriest K, Butz A. Neighborhood-level factors related to asthma in children living in urban areas. J Sch Nurs. 2017;33(1):8–17. https://doi.org/10.1177/1059840516674054.

    Article  PubMed  Google Scholar 

  6. Koinis-Mitchell D, McQuaid EL, Kopel SJ, et al. Cultural-related, contextual, and asthma-specific risks associated with asthma morbidity in urban children. J Clin Psychol Med Settings. 2010;17(1):38–48. https://doi.org/10.1007/s10880-009-9178-3.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Cooper PJ, Rodrigues LC, Barreto ML. Influence of poverty and infection on asthma in Latin America. Curr Opin Allergy Clin Immunol. 2012;12(2):171–8. https://doi.org/10.1097/ACI.0b013e3283510967.

    Article  PubMed  Google Scholar 

  8. Nyarko KA, Lopez-Camelo J, Castilla EE, Wehby GL. Explaining racial disparities in infant health in Brazil. Am J Public Health. 2013;103(9):1675–84. https://doi.org/10.2105/AJPH.2012.301021.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Barnthouse M, Jones BL. The impact of environmental chronic and toxic stress on asthma. Clin Rev Allergy Immunol. 2019;57(3):427–38. https://doi.org/10.1007/s12016-019-08736-x.

    Article  PubMed  Google Scholar 

  10. Yonas MA, Lange NE, Celedón JC. Psychosocial stress and asthma morbidity. Curr Opin Allergy Clin Immunol. 2012;12(2):202–10. https://doi.org/10.1097/ACI.0b013e32835090c9.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Williams DR, Lawrence JA, Davis BA, Vu C. Understanding how discrimination can affect health. Health Serv Res. 2019;54 Suppl 2(Suppl 2):1374–88. https://doi.org/10.1111/1475-6773.13222.

    Article  PubMed  Google Scholar 

  12. Cave L, Cooper MN, Zubrick SR, Shepherd CCJ. Caregiver-perceived racial discrimination is associated with diverse mental health outcomes in Aboriginal and Torres Strait Islander children aged 7–12 years. Int J Equity Health. 2019;18:142. https://doi.org/10.1186/s12939-019-1045-8.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Thakur N, Barcelo NE, Borrell LN, Singh S, Eng C, Davis A, et al. Perceived discrimination associated with asthma and related outcomes in minority youth: the GALA II and SAGE II studies. Chest. 2017;151(4):804–12. https://doi.org/10.1016/j.chest.2016.11.027.

    Article  PubMed  Google Scholar 

  14. Harrell SP. A multidimensional conceptualization of racism-related stress: implications for the well-being of people of color. Am J Orthop. 2000;70(1):42–57. https://doi.org/10.1037/h0087722.

    Article  CAS  Google Scholar 

  15. Kelly Y, Becares L, Nazroo J. Associations between maternal experiences of racism and early child health and development: findings from the UK Millennium Cohort Study. J Epidemiol Community Health. 2013;67:35–41. https://doi.org/10.1136/jech-2011-200814.

    Article  PubMed  Google Scholar 

  16. Priest N, Paradies Y, Stevens M, Bailie R. Exploring relationships between racism, housing and child illness in remote Indigenous communities. J Epidemiol Community Health. 2012;6(5):440–7.

    Article  Google Scholar 

  17. Bronfenbrenner U. Making human beings human: bioecological perspectives on human development. 1st ed. Thousand Oaks: Sage Publication; 2005.

    Google Scholar 

  18. Heard-Garris NJ, Cale M, Camaj L, Hamati MC, Dominguez TP. Transmitting trauma: a systematic review of vicarious racism and child health. Soc Sci Med. 2018;199:230–40. https://doi.org/10.1016/j.socscimed.2017.04.018.

    Article  CAS  PubMed  Google Scholar 

  19. Bécares L, Nazroo J, Kelly Y. A longitudinal examination of maternal, family, and area-level experiences of racism on children's socioemotional development: patterns and possible explanations. Soc Sci Med. 2015;142:128–35. https://doi.org/10.1016/j.socscimed.2015.08.025.

    Article  PubMed  Google Scholar 

  20. Paine SJ, Cormack D, Stanley J, Harris R. Caregiver experiences of racism are associated with adverse health outcomes for their children: a cross-sectional analysis of data from the New Zealand Health Survey. Crit Public Health. 2019;30:509–20. https://doi.org/10.1080/09581596.2019.1626003.

    Article  Google Scholar 

  21. Priest N, Paradies Y, Trenerry B, Truong M, Karlsen S, Kelly Y. A systematic review of studies examining the relationship between reported racism and health and wellbeing for children and young people. Soc Sci Med. 2013;95:115–27. https://doi.org/10.1016/j.socscimed.2012.11.031.

    Article  PubMed  Google Scholar 

  22. Zapolski TC, Fisher S, Hsu WW, Barnes J. What can parents do? Examining the role of parental support on the negative relationship between racial discrimination, depression, and drug use among African American youth. Clin Psychol Sci. 2016;4(4):718–31. https://doi.org/10.1177/2167702616646371.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Tran AG. Family contexts: parental experiences of discrimination and child mental health. Am J Community Psychol. 2014;53(1-2):37–46. https://doi.org/10.1007/s10464-013-9607-1.

    Article  PubMed  Google Scholar 

  24. Paine SJ, Harris R, Stanley J, Cormack D. Caregiver experiences of racism and child healthcare utilisation: cross-sectional analysis from New Zealand. Arch Dis Child. 2018;103(9):873–9. https://doi.org/10.1136/archdischild-2017-313866.

    Article  PubMed  Google Scholar 

  25. Shepherd CCJ, Li J, Cooper MN, Hopkins KD, Farrant BM. The impact of racial discrimination on the health of Australian Indigenous children aged 5-10 years: analysis of national longitudinal data. Int J Equity Health. 2017;16(1):116. Published 2017 Jul 3. https://doi.org/10.1186/s12939-017-0612-0.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Santos LM, Santos DN, Rodrigues LC, Barreto ML. Maternal mental health and social support: effect on childhood atopic and non-atopic asthma symptoms. J Epidemiol Community Health. 2012;66:1011–6. https://doi.org/10.1136/jech-2011-200278.

    Article  Google Scholar 

  27. Telles E. Race in another America: the significance of skin color in Brazil. Princeton, Oxford: Princeton University Press; 2004.

    Book  Google Scholar 

  28. Barreto ML, Cunha SS, Alcântara-Neves N, Carvalho LP, Cruz ÁA, Stein RT, et al. Risk factors and immunological pathways for asthma and other allergic diseases in children: background and methodology of a longitudinal study in a large urban center in Northeastern Brazil (Salvador-SCAALA study). BMC Pulm Med. 2006;6:15. https://doi.org/10.1186/1471-2466-6-15.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Krieger N, Smith K, Naishadham D, Hartman C, Barbeau EM. Experiences of discrimination: validity and reliability of a self-report measure for population health research on racism and health. Soc Sci Med. 2005;61(7):1576–96. https://doi.org/10.1016/j.socscimed.2005.03.006.

    Article  PubMed  Google Scholar 

  30. Fattore GL, Teles CA, Santos DN, Santos LM, Reichenheim ME, Barreto ML. Validade de constructo da escala Experiences of Discrimination em uma população brasileira [Validity of the Experiences of Discrimination scale in a Brazilian population]. Cad Saude Publica. 2016;32(4):e00102415. https://doi.org/10.1590/0102-311X00102415.

    Article  PubMed  Google Scholar 

  31. Fattore GL, Amorim LD, Santos DN, Santos LM, Barreto ML. Experiences of discrimination and skin color among women in urban Brazil: a latent class analysis. J Black Psychol. 2020;46(2-3):144–68. https://doi.org/10.1177/0095798420928204.

    Article  Google Scholar 

  32. Gonçalves DM, Stein AT, Kapczinski F. Avaliação de desempenho do Self-Reporting Questionnaire como instrumento de rastreamento psiquiátrico: um estudo comparativo com o Structured Clinical Interview for DSM-IV-TR. Cad Saude Publica. 2008;24(2):380–90. https://doi.org/10.1590/s0102-311x2008000200017.

    Article  PubMed  Google Scholar 

  33. Griep RH, Chor D, Faerstein E, Werneck GL, Lopes CS. Validade de constructo de escala de apoio social do Medical Outcomes Study adaptada para o português no Estudo Pró-Saúde. Cad Saude Publica. 2005;21(3):703–14. https://doi.org/10.1590/s0102-311x2005000300004.

    Article  PubMed  Google Scholar 

  34. Liang KY, Zeger SL. Longitudinal data analysis using generalized linear models. Biometrika. 1986;73(1):13–22. https://doi.org/10.2307/2336267.

    Article  Google Scholar 

  35. Mangan JM, Wittich AR, Gerald LB. The potential for reducing asthma disparities through improved family and social function and modified health behaviors. Chest. 2007;132(5 Suppl):789S–801S. https://doi.org/10.1378/chest.07-1908.

    Article  PubMed  Google Scholar 

  36. Sanders-Phillips K. Racial discrimination: a continuum of violence exposure for children of color. Clin Child Fam Psychol Rev. 2009;12(2):174–95. https://doi.org/10.1007/s10567-009-0053-4.

    Article  PubMed  Google Scholar 

  37. Hordge-Freeman E. What’s love got to do with it?: racial features, stigma and socialization in Afro-Brazilian families. Ethn Racial Stud. 2013;36(10):1507–23. https://doi.org/10.1080/01419870.2013.78820.

    Article  Google Scholar 

  38. Caldwell CH, Zimmerman MA, Bernat DH, Sellers RM, Notaro PC. Racial identity, maternal support, and psychological distress among African American adolescents. Child Dev. 2002;73(4):1322–36. https://doi.org/10.1111/1467-8624.00474.

    Article  PubMed  Google Scholar 

  39. Turyk ME, Hernandez E, Wright RJ, Freels S, Slezak J, Contraras A, et al. Stressful life events and asthma in adolescents. Pediatr Allergy Immunol. 2008;19(3):255–63. https://doi.org/10.1111/j.1399-3038.2007.00603.x.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We would like to thank all the parents and children who participated in this study.

Funding

This study is part of the SCAALA Programme (Social Change, Asthma and Allergy in Latin America), which is funded by The Welcome Trust, UK, Ref 072405/Z/03/Z. Complementary funds were received from the INCT/CNPq Programme Ref 610011/2009-0.

Author information

Authors and Affiliations

  1. Health Community Department, National University of Lanús, 29 de Septiembre 3901 (1826), Lanús, Buenos Aires, Argentina

    Gisel Lorena Fattore

  2. Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil

    Gisel Lorena Fattore, Leila D. Amorim, Letícia Marques dos Santos, Darci Neves dos Santos & Mauricio Lima Barreto

  3. Instituto de Matemática e Estatística, Universidade Federal da Bahia, Salvador, Brasil

    Leila D. Amorim

  4. Instituto de Humanidades Artes e Ciências Professor Milton Santos, Universidade Federal da Bahia, Salvador, Brasil

    Letícia Marques dos Santos

  5. Centro de Pesquisas Gonçalo Moniz, FIOCRUZ, Salvador, Brasil

    Mauricio Lima Barreto

Authors
  1. Gisel Lorena Fattore
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Leila D. Amorim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Letícia Marques dos Santos
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Darci Neves dos Santos
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mauricio Lima Barreto
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gisel Lorena Fattore.

Ethics declarations

Ethical Standards and Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. The study was approved in 2005 by the research ethics committee of the Institute of Collective Health at the Federal University in Bahia, under registration number 047-05/CEP-ISC. All participants signed a free and informed consent form, which contained detailed information about the data collection procedures for the research. Participants were informed of any results that suggested a need for medical/psychological care and were provided with relevant information about the health service.

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fattore, G.L., Amorim, L.D., dos Santos, L.M. et al. Asthmatic Symptoms in Children and Adolescents: the Role of Maternal Experiences of Racial Discrimination. J. Racial and Ethnic Health Disparities 9, 938–945 (2022). https://doi.org/10.1007/s40615-021-01032-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40615-021-01032-5

Keywords

Search

Navigation