biostudies-literatureCardet JCGlaxoSmithKlineNIAID NIH HHSNHLBI NIH HHSMerckPatient-Centered Outcomes Research InstituteNovartisNational Institute of Allergy and Infectious DiseasesRegeneron PharmaceuticalsGenentechNHLBIHarvard Medical SchoolAmerican Lung AssociationAstraZenecaSanofi841-849.e4https://www.ebi.ac.uk/biostudies/studies/S-EPMC9724153biostudies-literatureUnknown150(4)<h4>Background</h4>Asthma disproportionately affects African American/Black (AA/B) and Hispanic/Latinx (H/L) patients and individuals with low socioeconomic status (SES), but the relationship between SES and asthma morbidity within these racial/ethnic groups is inadequately understood.<h4>Objective</h4>To determine the relationship between SES and asthma morbidity among AA/B and H/L adults with moderate to severe asthma using multidomain SES frameworks and mediation analyses.<h4>Methods</h4>We analyzed enrollment data from the PeRson EmPowered Asthma RElief randomized trial, evaluating inhaled corticosteroid supplementation to rescue therapy. We tested for direct and indirect relationships between SES and asthma morbidity using structural equation models. For SES, we used a latent variable defined by poverty, education, and unemployment. For asthma morbidity, we used self-reported asthma exacerbations in the year before enrollment (corticosteroid bursts, emergency room/urgent care visits, or hospitalizations), and Asthma Control Test scores. We tested for mediation via health literacy, perceived stress, and self-reported discrimination. All models adjusted for age, sex, body mass index, ethnicity, and comorbidities.<h4>Results</h4>Among 990 AA/B and H/L adults, low SES (latent variable) was directly associated with hospitalizations (β = 0.24) and worse Asthma Control Test scores (β = 0.20). Stress partially mediated the relationship between SES and increased emergency room/urgent care visits and worse asthma control (β = 0.03 and = 0.05, respectively). Individual SES domains were directly associated with asthma morbidity. Stress mediated indirect associations between low educational attainment and unemployment with worse asthma control (β = 0.05 and = 0.06, respectively).<h4>Conclusions</h4>Lower SES is directly, and indirectly through stress, associated with asthma morbidity among AA/B and H/L adults. Identification of stressors and relevant management strategies may lessen asthma-related morbidity among these populations.The Journal of allergy and clinical immunologySocioeconomic status associates with worse asthma morbidity among Black and Latinx adults.PMC9724153K23AI125785K24 AI106822PCS-1504-30283K24 AI 106822AI-835475L30 HL143781K23 AI125785Fuhlbrigge ALPace WDShields JBCoyne-Beasley TMaher NEHernandez PACui JKruse JLouisias MWisnivesky JPCardet JCCarroll JKCeledon JCForth VEEricson BIsrael EFagan MManning BRodriguez-Louis JChang KLRooks BJPhipatanakul WfalseSocioeconomic status associates with worse asthma morbidity among Black and Latinx adults.<h4>Background</h4>Asthma disproportionately affects African American/Black (AA/B) and Hispanic/Latinx (H/L) patients and individuals with low socioeconomic status (SES), but the relationship between SES and asthma morbidity within these racial/ethnic groups is inadequately understood.<h4>Objective</h4>To determine the relationship between SES and asthma morbidity among AA/B and H/L adults with moderate to severe asthma using multidomain SES frameworks and mediation analyses.<h4>Methods</h4>We analyzed enrollment data from the PeRson EmPowered Asthma RElief randomized trial, evaluating inhaled corticosteroid supplementation to rescue therapy. We tested for direct and indirect relationships between SES and asthma morbidity using structural equation models. For SES, we used a latent variable defined by poverty, education, and unemployment. For asthma morbidity, we used self-reported asthma exacerbations in the year before enrollment (corticosteroid bursts, emergency room/urgent care visits, or hospitalizations), and Asthma Control Test scores. We tested for mediation via health literacy, perceived stress, and self-reported discrimination. All models adjusted for age, sex, body mass index, ethnicity, and comorbidities.<h4>Results</h4>Among 990 AA/B and H/L adults, low SES (latent variable) was directly associated with hospitalizations (β = 0.24) and worse Asthma Control Test scores (β = 0.20). Stress partially mediated the relationship between SES and increased emergency room/urgent care visits and worse asthma control (β = 0.03 and = 0.05, respectively). Individual SES domains were directly associated with asthma morbidity. Stress mediated indirect associations between low educational attainment and unemployment with worse asthma control (β = 0.05 and = 0.06, respectively).<h4>Conclusions</h4>Lower SES is directly, and indirectly through stress, associated with asthma morbidity among AA/B and H/L adults. Identification of stressors and relevant management strategies may lessen asthma-related morbidity among these populations.2022-01-01T00:00:00Z2022 Oct2026-06-02T16:16:13.94Z2025-04-04T23:20:13.778ZS-EPMC97241533559737010.1016/j.jaci.2022.04.030