Researchers recommended further intense examination of racism as a contributing factor to poor health outcomes in minority communities, especially among young black children with asthma.

 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.

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