Background: Asthma is one of the most common chronic diseases diagnosed in children today, and some minority populations constitute a much higher incidence of asthma than others. Many factors are known to play into the development of asthma, including genetics, smoking history, and psychosocial stress. Experiencing childhood racism may be one type of stressor that contributes to the development of asthma and poor asthma outcomes. This study aims to identify the effect of experienced racism on asthma outcomes in minority children.
Methods: An exhaustive search of available medical literature was conducted using the databases MEDLINE – PubMed, CINAHL, and Web of Science. An age filter was applied in all databases encompassing children from birth to 21 years old. The key terms used were asthma and racism. Eligibility criteria included English language and human-only studies. Articles must also have included at least one measured asthma outcome and involved minority participants. Studies were assessed for quality using GRADE criteria.
Results: The search produced 2 available studies that met search criteria, both being case-control studies. Although measuring different asthma outcomes, the studies suggested that African American children who report experiencing racism to any degree have a higher incidence of asthma, and are more likely to have poorly controlled asthma. Data on other minorities showed mixed results. The overall quality of evidence provided is low for asthma incidence and very low for poor asthma control.
Conclusion: The data suggested that for African American children, those who reported experiencing racism were more likely to have asthma, more likely to have poorly controlled asthma, and had a higher bronchodilator (BDR) response. One study’s data on other minority children showed mixed results, and different asthma phenotypes may also play a role in susceptibility. Further studies are needed, particularly cohort studies, to further determine the effects of racism on asthma in different minority populations, and to increase our confidence in the results. This may help us understand if additional screening is needed for children who may be at risk for asthma and poor asthma outcomes, and to help aid in treatment plans.
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