Han Yueh-Ying, Chen Wei, Forno Erick, Perreira Krista M, Oren Eyal, Daviglus Martha, Garcia-Bedoya Olga, Kaplan Robert, Isasi Carmen R, Celedón Juan C
Division of Pediatric Pulmonary Medicine, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania.
Division of Pulmonary, Allergy, and Sleep Medicine, Riley Children's Hospital, Indiana University School of Medicine, Indianapolis, Indiana.
Ann Am Thorac Soc. 2025 Apr;22(4):549-559. doi: 10.1513/AnnalsATS.202407-705OC.
Hispanic/Latino adults commonly experience high psychosocial stress; yet, little is known about the pathways linking sociocultural stressors and asthma in this population. To study whether and how sociocultural stressors are associated with asthma in Hispanic/Latino adults. We conducted a cross-sectional study of 4,759 adults aged 18 to 74 years who participated in the Sociocultural Ancillary Study of the Hispanic Community Health Study/Study of Latinos. All participants completed a sociocultural assessment, including acculturative stress, perceived ethnic discrimination, neighborhood problems, neighborhood social cohesion, and a cumulative measure of all sociocultural stressors. Weighted multivariable logistic regression accounting for sampling design was used for the analysis of sociocultural stressors and current asthma or current asthma symptoms. A mediation analysis was conducted to estimate the contributions of depressive symptoms and anxiety to the cumulative sociocultural stressors-asthma association. Acculturative stress and neighborhood problems were associated with 1.4 to 2.1 times higher odds of current asthma or current asthma symptoms, and perceived ethnic discrimination was associated with 1.4 times higher odds of current asthma symptoms. Neighborhood social cohesion was associated with 0.6 times lower odds of asthma. Cumulative sociocultural stressors were associated with 1.6 times higher odds of current asthma symptoms (odds ratio for below the median versus greater than or equal to the median value, 1.60; 95% confidence interval, 1.29, 1.99). Depressive symptoms and anxiety explained 26% and 22%, respectively, of the association between cumulative sociocultural stressors and asthma symptoms. Among Hispanic/Latino adults, sociocultural stressors were associated with current asthma or asthma symptoms. Depressive symptoms and anxiety partly mediated this association. Clinicians caring for Hispanic/Latino adults with asthma should be aware of potential stressors and comorbidities such as depression and anxiety.
西班牙裔/拉丁裔成年人普遍承受着较高的心理社会压力；然而，对于该人群中社会文化压力源与哮喘之间的关联途径，我们却知之甚少。为了研究社会文化压力源是否以及如何与西班牙裔/拉丁裔成年人的哮喘相关联，我们对4759名年龄在18至74岁之间、参与了西班牙裔社区健康研究/拉丁裔研究社会文化辅助研究的成年人进行了一项横断面研究。所有参与者都完成了一项社会文化评估，包括文化适应压力、感知到的种族歧视、邻里问题、邻里社会凝聚力，以及所有社会文化压力源的累积指标。采用考虑抽样设计的加权多变量逻辑回归分析社会文化压力源与当前哮喘或当前哮喘症状之间的关系。进行了中介分析，以估计抑郁症状和焦虑对累积社会文化压力源与哮喘关联的贡献。文化适应压力和邻里问题与当前哮喘或当前哮喘症状的几率高出1.4至2.1倍相关，而感知到的种族歧视与当前哮喘症状的几率高出1.4倍相关。邻里社会凝聚力与哮喘几率低0.6倍相关。累积社会文化压力源与当前哮喘症状的几率高出1.6倍相关（低于中位数与大于或等于中位数的比值比，1.60；95%置信区间，1.29，1.99）。抑郁症状和焦虑分别解释了累积社会文化压力源与哮喘症状之间关联的26%和22%。在西班牙裔/拉丁裔成年人中，社会文化压力源与当前哮喘或哮喘症状相关。抑郁症状和焦虑部分介导了这种关联。照顾患有哮喘的西班牙裔/拉丁裔成年人的临床医生应意识到潜在的压力源和共病，如抑郁和焦虑。
