Parental language and asthma among urban Hispanic children
Received 2 October 2006; received in revised form 22 August 2007; accepted 22 August 2007.
Background
Many Hispanics in the United States have limited English proficiency and prefer communicating in Spanish. Language barriers are known to adversely affect health care quality and outcomes.
Objective
We explored the relationship between parent language preference in a Hispanic population and the likelihood that a child with symptoms receives a diagnosis of asthma.
Methods
We conducted a school-based survey in 105 Chicago public and Catholic schools. Our sample included 14,177 Hispanic children 6 to 12 years of age with a parent who completed an asthma survey. Outcomes of diagnosed asthma and possible asthma (asthma symptoms without diagnosis) were assessed by using the Brief Pediatric Asthma Screen Plus instrument.
Results
Overall, 12.0% of children had diagnosed asthma, and 12.7% had possible asthma. Parents of children at risk who completed the survey in English reported higher rates of asthma diagnosis compared with parents who completed it in Spanish (55.2% vs 36.3%, P < .001). Predictors of asthma diagnosis were child sex, parental language preference, parental asthma status, and other household members with asthma.
Conclusions
Parental language preference might be an important characteristic associated with childhood asthma diagnosis. Whether language itself is the key factor or the fact that language is a surrogate for other attributes of acculturation needs to be explored.
Clinical implications
Our findings suggest that estimates of asthma among Hispanic schoolchildren might be low because of underdiagnosis among children whose parents prefer communicating in Spanish.
aDepartment of Immunology and Microbiology, Rush Medical College, Chicago, Ill
bCollaborative Research Unit, Department of Medicine, Cook County Bureau of Health Services and Rush Medical College, Chicago, Ill
cDepartment of Preventive Medicine and Epidemiology, Loyola University Stritch School of Medicine, Chicago, Ill
dDepartment of Medicine, Section of Health Promotion Research, University of Illinois at Chicago, Chicago, Ill
eInstitute for Healthcare Studies, Northwestern University, Chicago, Ill
fEvanston Northwestern Healthcare, Northwestern University Feinberg School of Medicine, Chicago, Ill
gDivisions of Pulmonary and Critical Care Medicine, Stroger Hospital of Cook County, Chicago, Ill
Reprint requests: Giselle Mosnaim, MD, MS, Department of Immunology and Microbiology, Rush Medical College, 1725 West Harrison, Suite 117, Chicago, IL 60612.
Supported by a grant from the National Heart, Lung, and Blood Institute (1-U01 HL 72496-1) sponsoring the Chicago Initiative to Raise Asthma Health Equity.
Disclosure of potential conflict of interest: G. S. Mosnaim has consulting arrangements with GlaxoSmithKline, owns stock in Electrocore, and is on the speakers' bureau for the Respiratory and Allergic Disease Foundation, Sanofi-Aventis, Schering-Plough, Merck, GlaxoSmithKline, and AstraZeneca. R. A. Durazo-Arvizu and J. J. Shannon have received grant support from the National Heart, Lung, and Blood Institute. L. M. Curtis has received grant support from the National Institutes of Health. The rest of the authors have declared that they have no conflict of interest.
ABSTRACT