Participants included 133 urban, low-income children with asthma between the ages of 6 and 13 years [mean (SD)=9.83 (1.61)] and their primary caregivers. Of the families enrolled, 52 self-identified as Latino, 47 self-identified as non–Latino White, and 34 self-identified as African American. Forty-seven percent of the sample reported being below poverty threshold, 67% of the sample reported being on a controller medication, and 32% of children reported at least one ED visit over the last year. (See for demographic information by ethnicity.) Of the possible covariates, only poverty was significantly associated with reported environmental control (r
<0.01) and functional limitation (r
<0.01). Poverty was significantly related to ethnicity (P
<0.001); Latino families were more likely to report higher levels of poverty.
Child and Caregiver Demographic Characteristics by Ethnic Group
Ethnic differences in reported environmental control
Reported environmental control scores significantly differed by ethnicity (R2=0.02; P<0.05), with Latino families reporting the highest level of environmental control (see for mean scale scores by ethnicity). Post hoc comparisons using Tukey's Honestly Significant Difference test indicated that the mean score for Latinos was significantly different from that for non–Latino Whites (d=0.50; P<0.05). African American scores on the FAMSS subscale did not significantly differ from Latino or non–Latino White scores. After adjusting for the effects of poverty, the association between ethnicity and environmental control approached statistical significance (R2=0.08; P=0.055).
Associations between reported environmental control and asthma outcomes
Scores on the environmental control subscale of the FAMSS ranged from 1 to 8, with a mean score of 3.05 (SD=2.53) reported for the sample. Reported environmental control was significantly associated with asthma control (d=0.66, P<0.017) and functional limitation (r=−0.21, P<0.017). In both cases, more optimal environmental control was associated with more positive asthma control and lower levels of functional limitation. Controlling for poverty, reported environmental control and asthma control were still significantly associated (R2=0.08; P<0.017). Reported environmental control and functional limitation were associated at a trend level (R2=0.09; P=0.06).
The association between reported environmental control and ED use was significant for Latino families only (d=0.76; P<0.05). This effect remained significant after controlling for poverty (OR=0.72; P<0.05). Associations between reported environmental control and functional limitation were significant only among non–Latino Whites (r=−0.32, P<0.05). When controlling for poverty, this association remained at P=0.05 (r=−0.30).
Ethnic differences in specific exposures
Ethnic differences in exposure to triggers can be found in . Non–Latino White families were significantly more likely than Latino families to report a cat in the home. Both African American and Latino families were significantly more likely than non–Latino White families to report cockroaches in the home. African American and non–Latino White families were more likely to report secondhand smoke exposure than Latino families (70% of non–Latino White, 66% of African American, and 31% of Latino families; P<0.001).
Reported Environmental Triggers in Full Sample and by Ethnic Group
Associations between environmental triggers and asthma outcomes
In the full sample, child functional limitation differed by the presence of carpeting in the family room (d=0.44; P<0.017); more functional limitation was reported in homes with family room carpeting. In Latino families, ED use was associated with secondhand smoke (OR=4.34; P<0.05) and carpeting in the family room (OR=3.43; P=0.05). In non–Latino White families, functional limitation differed by secondhand smoke (d=0.98; P<0.05) and by the presence of a pet in the home (d=0.78; P<0.05); higher levels of functional limitation were found in homes with reported secondhand smoke exposure or the presence of a pet.