Parchem Benjamin, Gower Amy L, Eisenberg Marla E, Lawrence Samantha E, Gonzales Real André, Suresh Malavika, Ip Ka I, Rider G Nic
Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School.
Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota.
Health Psychol. 2025 Apr;44(4):401-407. doi: 10.1037/hea0001430. Epub 2024 Oct 21.
This study aimed to examine asthma disparities at the intersection of four sociodemographic characteristics, inhaled substance use, and bias-based bullying as metrics of stigma. We hypothesized that high prevalence groups for asthma would be those with marginalized social positions and those reporting bullying experiences, independent of inhaled substance use.
The analytic sample ( = 90,367) included eighth, ninth, and 11th grade students who participated in the 2022 Minnesota Student Survey. Exhaustive Chi-square Automatic Interaction Detection tested all combinations of sociodemographic characteristics (gender identity, sexual orientation, racial/ethnic identity, and access to resources), inhaled substance use (none vs. any), and bias-based bullying about sexuality, gender identity/expression, racial identity, and weight/size to predict mutually exclusive groups of youth based on self-reported asthma diagnosis.
Approximately 15% of the sample reported asthma. Sexually, gender, and racially/ethnically diverse youth reported higher rates of asthma relative to their heterosexual, cisgender, and White counterparts. High prevalence groups for asthma (rates between 24% and 41%) were characterized by having multiple marginalized identities, experiencing bias-based bullying, and engaging in inhaled substance use. Three of the 10 intersectional groups with a high prevalence of asthma were not inhaled substance users.
These findings suggest that stigma may help explain the asthma disparities among marginalized youth. Efforts to reduce asthma disparities in marginalized youth should move beyond pathologizing the individual through overfocusing on health behaviors and attend to root causes, like experiences of stigma. Future studies should examine systemic inflammation as the potential connection between stigma and asthma. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
本研究旨在探讨哮喘在四个社会人口学特征、吸入性物质使用以及基于偏见的欺凌（作为耻辱感指标）交叉点上的差异。我们假设，哮喘高患病率群体将是那些处于社会边缘地位且报告有欺凌经历的群体，与吸入性物质使用无关。
分析样本（n = 90367）包括参加2022年明尼苏达学生调查的八年级、九年级和十一年级学生。详尽的卡方自动交互检测测试了社会人口学特征（性别认同、性取向、种族/族裔认同和资源获取情况）、吸入性物质使用（无使用与有使用）以及基于性取向、性别认同/表达、种族认同和体重/体型的偏见性欺凌的所有组合，以根据自我报告的哮喘诊断预测相互排斥的青少年群体。
约15%的样本报告患有哮喘。性取向、性别和种族/族裔多样化的青少年报告的哮喘患病率高于其异性恋、顺性别和白人同龄人。哮喘高患病率群体（患病率在24%至41%之间）的特征是具有多种边缘化身份、经历基于偏见的欺凌以及使用吸入性物质。10个哮喘高患病率交叉群体中有3个不是吸入性物质使用者。
这些发现表明，耻辱感可能有助于解释边缘化青少年中的哮喘差异。减少边缘化青少年哮喘差异的努力不应仅仅通过过度关注健康行为将个体病理化，而应关注根本原因，如耻辱感经历。未来的研究应将系统性炎症作为耻辱感与哮喘之间的潜在联系进行研究。（PsycInfo数据库记录（c）2025美国心理学会，保留所有权利）
