Does Racism Influence Increased Prevalence of Asthma in Black Children?

Pediatric asthma
Pediatric asthma
The continual threat of racism brings about chronic stress exposure for black children with asthma and may be a factor in the higher prevalence of childhood asthma in black populations.

Chronic stress exposure brought about through the persistent threat of racism may play a role in the higher prevalence of childhood asthma in black populations, according to results of a recent pilot study published in the Annals of Allergy, Asthma & Immunology.

Investigators assessed chronic stress within 7 domains: home and caretaker instability, food insecurity, racism/discrimination, neighborhood disorder and violence, family abuse/violence, parental depression/mental health, and issues related to urban life.

They administered the following questionnaires to parents/guardians of urban-dwelling self-identified black children aged 1 to 6 years with an asthma diagnosis by a physician:

  • 6-item US Food Security Scale
  • Crisis in family systems
  • Schedule of racist events
  • Expanded Adverse Childhood Experiences questionnaire
  • The Patient Health Questionnaire and housing/caregiver instability

The researchers evaluated asthma control using the Asthma Control Test or the Test for Respiratory and Asthma Control in Kids questionnaire. They gauged associations between questionnaire scores.

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A total of 31 parents/guardians completed the asthma control and stress questionnaires. Of the children, 47% had previously required hospitalization for asthma, and 27% had required intensive care support during asthma hospitalization. The authors found an inverse correlation between Test for Respiratory and Asthma Control in Kids score and stress as a result of racism. Furthermore, increased experiences of racism identified by the parents/guardians as stressful were associated with lower asthma control in the child.

The study authors wrote, “Given the multifaceted and direct/indirect effects of racism and discrimination on the daily life of individuals and the compounded generational and community-level impact, this factor requires further rigorous consideration as a contributor to poor health outcomes in minoritized communities in the United States especially among young children in whom long-term effects may be cumulative.”

They added, “Correlations between [the Asthma Control Test] and housing, food insecurity, and conventional [adverse childhood experiences] merit further study with larger samples.”


Jones BL, Staggs V, Woods-Jaeger B. Chronic stress exposure among young African American children with asthma: racism is a factor [published online September 3, 2019]. Ann Allergy Asthma Immunol. doi:10.1016/j.anai.2019.08.023