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Black Children May Benefit from Race-Neutral Assessments for Asthma Diagnosis, Study Finds

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Black Children May Benefit from Race-Neutral Assessments for Asthma Diagnosis, Study Finds

Authors: Amy Non, James Gern, et al.

 

Who sponsored this study?

The Environmental influences on Child Health Outcomes (ECHO) Program, National Institutes of Health supported this research.

 

Why was this study needed?

Spirometry (spy-ROM-uh-tree) is a test used to check how well your lungs work. It measures how much air you breathe in, how much you breathe out, and how quickly you breathe out. Healthcare professionals use spirometry to diagnose asthma and other respiratory conditions. Historically, healthcare providers have used different spirometry equations based on a person’s race for interpreting test results, relying on the assumption that Black and White bodies are biologically different. For this study, researchers wanted to know whether using the same spirometry equations for everyone (race-neutral) or different ones for specific races (race-specific) changes the reliability of lung function tests used to check for asthma in children. This research addresses concerns that race-specific test interpretations might hide lung problems in children from certain backgrounds and could lead to differences in how asthma is diagnosed and treated in kids from racial and ethnic minority groups.

 

What were the study results?

Black children may be more likely to be identified as having reduced lung function when doctors use the same spirometry equations to interpret test results for everyone (race-neutral) instead of race-specific ones.  The study found that using the race-neutral equations resulted in significantly lower lung function scores for Black children compared to the race-specific equations. This led to a higher percentage of Black children being classified as having low lung function. Furthermore, Black children were more likely to be diagnosed with asthma, regardless of the equation The way lung function was measured did not seem to make much difference in how often children needed asthma-related healthcare, like emergency room visits or hospital stays.

 

What was the study's impact?

The study's findings support using race-neutral equations when evaluating children for asthma, as they may provide a more uniform assessment of lung function across different racial and ethnic groups.

 

Who was involved?

The research included 8,719 children aged 5 to 12 years from 27 research sites across the United States. These children were grouped by parent-reported race and ethnicity, including Black, non-White Hispanic, and White children, with a smaller percentage classified as "Other Race."

 

What happened during the study?

The study examined how using the same equations for everyone changes how lung function tests are understood. These tests measure how much air a child can blow out in one second, the total amount of air they can blow out in one breath, and the balance between the two. Researchers also checked if the test results matched real-life asthma problems, like being diagnosed with asthma, needing emergency care, or staying in the hospital.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What happens next?

Further research is needed to better understand the racial differences in lung function and asthma outcomes. Future studies could also explore the impact of environmental and social factors affect respiratory health in children from different racial and ethnic groups.

 

Where can I learn more?

Access the full journal article, titled “Comparison of Race-neutral Versus Race-specific Spirometry Equations for Evaluation of Child Asthma,” in American Journal of Respiratory and Critical Care Medicine.

 

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published December 3, 2024

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Black Children May Benefit from Race-Neutral Assessments for Asthma Diagnosis, Study Finds

 

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ECHO-funded Research Finds Higher Asthma Rates Among Black and Hispanic Children Regardless of Neighborhood Income or Density

Posted on by Jodi Snare

A new ECHO study found that although there is a correlation between childhood asthma and being born into a densely populated or lower-income neighborhood, Black and Hispanic children had consistently higher rates of asthma than White children, even in wealthier neighborhoods.

The study, led by ECHO investigators, Dr. Antonella Zanobetti, Harvard T.H Chan School of Public Health, Department of Environmental Health, and Dr. Patrick H. Ryan, Cincinnati Children’s Hospital Medical Center, included data from 5,809 children born over four decades throughout the United States, providing important insight into how racial and ethnic health inequities may cause children to develop wheezing – a symptom involving whistling breathing sounds due to narrowed airways – and asthma.

Of the 5,809 children studied, 46% reported wheezing prior to age 2 and 26% reported persistent wheeze through age 11. Diagnosis of asthma by age 11 varied by cohort, with an overall median prevalence of 25%. Children in neighborhoods with higher population density, and with more families with lower incomes and living below the poverty level, experienced more asthma and early and persistent wheezing. Black and Hispanic children remained at higher risk for asthma than White children, even in neighborhoods with more resources.

Researchers used questionnaires and interviews to collect information such as wheezing and asthma occurrence, medical history, and demographics from participating families over many years. Each child’s home address was matched to U.S. Census tract data for the decade closest to their birth year. Researchers examined the relationship between incidence of wheezing and asthma with children’s race and ethnicity, their mother’s education level and smoking habits, and socioeconomic conditions of the neighborhood in which they were born.

“Neighborhood- and individual-level characteristics and their root causes should be considered as sources of respiratory health inequities,” Dr. Zanobetti said. “Reducing these inequities requires identifying and repairing differences between and within neighborhoods to create equal access to healthy living conditions.”

This research, titled “Childhood Asthma Incidence, Early and Persistent Wheeze, and Neighborhood Socioeconomic Factors in the ECHO/CREW Consortium,” is published in JAMA Pediatrics.

Read the Research Summary.