Poster - #UCLAFSPH-30 - Keywords: Social determinants of health asthma children Asian American disaggregated hay fever food allergy skin allergy respiratory allergy

Association Between Social Determinants of Health and Allergic Disease Prevalence Among Asian American Children

Vivian Bui(1); Austin Le(2); Richie Chu(3,4); Anna Chen Arroyo, MD, MPH(5,6); Meng Chen, MD(5,6); Adrian M. Bacong, PhD, MPH(6,7)
1 Division of Epidemiology, University of California, Berkeley, School of Public Health 2 Division of Environmental Health Sciences, University of California, Berkeley, School of Public Health 3 Department of Community Health Sciences, University of California, Los Angeles, Fielding School of Public Health 4 Asian American Studies Department, University of California, Los Angeles 5 Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA 6 Center for Asian Health Research and Education, Stanford University School of Medicine, Stanford, CA 7 Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA

ABSTRACT:
Introduction: Although disparities in allergic diseases are seen for certain racial and ethnic groups, little is known about the relationship between social determinants of health (SDoH) and allergic disease prevalence among Asian American (AsA) subgroups due to historic aggregation of AsA data. Methods: Our analysis used the 2011-2018 National Health Interview Survey, examining parent-reported race and ethnicity, SDoH (financial stability, healthcare access, food security, neighborhood quality, and education) and allergic diseases (hay fever, food allergy, skin allergy, respiratory allergy, and ever and current asthma). Rao-Scott Chi Square test compared survey-weighted allergic disease prevalence by Asian subgroup. Subgroup-stratified multivariable logistic regression accounting for age, sex, and child/parent nativity modeled the association between SDoH and allergic disease prevalence. Results: Approximately 5,042 non-Hispanic AsA children (26% Asian Indian, 18% Chinese, 21% Filipino/a, 35% Other Asian) were included. For any allergic disease, the prevalence ranged from 20% (95% CI:18%-23%) among Asian Indian children to 30% (95%CI:26%-33%) among Filipino/a children, compared to 25% in AsA (95%CI:24%-27%) children. Allergic outcome prevalence differed by subgroup. For example, ever asthma was lowest among Chinese children (7%; 95%CI:5%-10%) and highest among Filipino/a children (15%; 95%CI:13%-18%). In adjusted stratified analyses, financial instability was associated with higher odds of current asthma (OR=2.10 [95%CI:1.34,3.29]) among Asian Indian children, but not for Chinese or Filipino/a children (OR= 2.07 [95%CI:0.90-4.82] and OR=1.19 [95% CI:0.66-2.16]), respectively. Conclusion: There was heterogeneity in allergic disease prevalence and its association with SDoH among AsA children. Further study of SDoH may inform modifiable environmental factors for allergic disease among AsA children.