Ethnic differences in perception of lung function: a factor in pediatric asthma disparities?

Area of Science:

• Pediatric Pulmonology
• Health Disparities Research
• Cross-cultural Health Studies

Background:

• Significant disparities exist in pediatric asthma, with higher prevalence and morbidity observed in Latino children compared to non-Latino white children.
• Underlying factors contributing to these disparities are not fully understood, but may involve ethnic variations in the ability to perceive and report pulmonary function accurately.

Purpose of the Study:

• To investigate differences in perceptual accuracy of pulmonary function between Latino and non-Latino white children.
• To determine if these perceptual differences are associated with asthma outcomes and healthcare utilization.

Main Methods:

• A 5-week home-based protocol involving 512 children (aged 7-16) from diverse ethnic backgrounds (Puerto Rican, Rhode Island Latino, Rhode Island non-Latino white).
• Participants provided subjective estimates of peak expiratory flow rate (PEFR) alongside objective spirometry measurements twice daily.
• Analyses controlled for demographic factors, asthma severity, intelligence, emotional expression, and symptom reporting tendencies.

Main Results:

• Lower perceptual accuracy was associated with younger age, female sex, lower intelligence, and poverty.
• Island Puerto Rican children exhibited the lowest accuracy and highest "magnification" scores, followed by Rhode Island Latinos, with both groups differing significantly from non-Latino white children.
• Perceptual accuracy scores were significantly correlated with multiple indices of asthma morbidity.

Conclusions:

• Ethnicity was independently related to pulmonary function perception ability, with Latino children demonstrating less accuracy than non-Latino white children.
• This ethnic disparity in perceptual ability is a potential contributing factor to the observed disparities in pediatric asthma outcomes.