Homeownership, Asthma, and Fractional Excretion of Nitric Oxide in Children and Adolescents Aged Six to Nineteen Years: NHANES Survey

19 Pages Posted: 11 Oct 2021

See all articles by Zavia Hammond

Zavia Hammond

Howard University College of Medicine

Louis Nicolas

Howard University College of Medicine

Kyla Bass

Howard University College of Medicine

Richard Gillum

Howard University

Date Written: September 22, 2021

Abstract

Background and Objectives.
Racial disparities in asthma prevalence and severity have been well documented. Racial disparities in accumulated wealth far exceed those in annual income and education. Wealth can be defined as an individual’s assets while income can be defined as the amount of money that comes into the household. Wealth may be related to health by enabling an individual to access preventive and therapeutic care. Yet, few studies of asthma have considered wealth in their analyses. Fractional exhaled nitric oxide (FeNO), a noninvasive marker of airway inflammation, is used as an indicator of quality of asthma care. This study tested the hypotheses that (1) home ownership, a measure of family wealth, was associated with asthma prevalence, emergency department visits for asthma and FeNO, (2) FeNO is a mediator of the association between home ownership and asthma, and (3) race is related to asthma and FeNO independent of home ownership.

Research Design and Methods.
In the National Health and Nutrition Examination Survey (NHANES), 7,219 participants aged 6-19 years were interviewed, of which 6,991 were also examined between 2007-2012. Of those interviewed, 6,972 had complete data on asthma prevalence and home ownership. The ratio of family income to poverty was calculated by dividing family income by the poverty guidelines specific to the survey year. This variable was dichotomized at 185% of the federal poverty limit, a commonly used cut point and was only available for 5,807. FeNO was measured using the Aerocrine NIOX MINO®, which relies on an electrochemical sensor to detect exhaled nitric oxide levels. Reproducible FeNO measurements were available for 6,299 participants. Interviewers asked parents about previous and current diagnosis of asthma. Weighted regression analyses were performed taking the complex survey design into account using STATA V.17.

Results.
Among children whose family did not own a home, 20% reported ever having asthma. Among those families that did own a home, 18% reported ever having asthma (p=0.41), with an overall 19% asthma rate. After controlling for age, gender, black race, and Hispanic ethnicity, the OR was 0.77 (95% CI 0.58-1.01, P= 0.065) for the chance of having asthma among children whose families owned their home. Home ownership was not associated with ever having asthma after controlling for age, gender, black race, Hispanic ethnicity, and family poverty ratio. However, black race and Hispanic ethnicity were significantly associated with asthma diagnosis (P < 0.01). No association was found between home ownership, emergency department visits or FeNO.

Conclusion.
Black race and Hispanic ethnicity were significantly associated with prevalence of asthma, emergency department visits and FeNO. However, homeownership was not associated with asthma prevalence or FeNO.

Note:
Funding Information: None to declare.

Declaration of Interests: None to declare.

Ethics Approval Statement: The National Center for Health Statistics Research Ethics Review Board approved all protocols. All participants provided informed consent.

Keywords: Asthma, Children, Homeownership, Fractional exhaled nitric oxide, Socioeconomic Factors, Wealth

Suggested Citation

Hammond, Zavia and Nicolas, Louis and Bass, Kyla and Gillum, Richard, Homeownership, Asthma, and Fractional Excretion of Nitric Oxide in Children and Adolescents Aged Six to Nineteen Years: NHANES Survey (September 22, 2021). Available at SSRN: https://ssrn.com/abstract=3920560 or http://dx.doi.org/10.2139/ssrn.3920560

Zavia Hammond (Contact Author)

Howard University College of Medicine ( email )

520 W St NW
Washington, DC 20059
United States

Louis Nicolas

Howard University College of Medicine ( email )

520 W St NW
Washington, DC 20059
United States

Kyla Bass

Howard University College of Medicine ( email )

520 W St NW
Washington, DC 20059
United States

Richard Gillum

Howard University ( email )

2900 Van Ness Street, N.W.
Washington, DC 20008
United States

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