Asthma Remission Disparities among U.S. Youth by Sexual Identity and Race/Ethnicity, 2009-2017

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J Allergy Clin Immunol Pract. 2021 May 5:S2213-2198(21)00508-0. doi: 10.1016/j.jaip.2021.04.046. Online ahead of print.

ABSTRACT

BACKGROUND: Sexual minority and racial/ethnic minority youth experience a higher burden of asthma. The frameworks of minority stress theory and intersectionality suggest sexual minority and racial/ethnic minority youth may experience disparities in non-remitting asthma.

OBJECTIVE: To examine adjusted odds of non-remitting asthma by sexual identity, race/ethnicity, and their intersections, along with their relationship with traditional non-remitting asthma risk factors (weight status and smoking) and victimization (bullying, cyberbullying, and forced sex).

METHOD: We utilized data from the Youth Risk Behavior Survey (YRBS) pooled across 41 jurisdiction-years (biennially, 2009-2017), resulting in a sample of 21,789 U.S. youth. The prevalence of non-remitting asthma was examined by sexual identity, race/ethnicity, and their intersections, stratified by sex. Bivariate associations and backward logistic regression models, stratified by sex, were built to examine non-remitting asthma disparities and the effects of selected traditional correlates and victimization variables.

RESULTS: At the intersections, 8 sexual minority and racial/ethnic minority subpopulations were significantly more likely to have non-remitting asthma compared with White heterosexual sex-matched peers. White gay males and Black lesbian females had the highest odds of non-remitting asthma. Traditional risks of non-remitting asthma and victimization were associated with attenuated odds of non-remitting asthma.

CONCLUSION: Many sexual minority and racial/ethnic youth sub-populations are more likely to have non-remitting asthma. Evidence suggests traditional non-remitting asthma risk factors and victimization may partly explain disparities in non-remitting asthma. Asthma management guidelines should be updated to include population health disparities of sexual and racial/ethnic minorities.

PMID:33964511 | DOI:10.1016/j.jaip.2021.04.046