Sociocultural Stressors and Asthma among Adults in the Hispanic Community Health Study / Study of Latinos (HCHS/SOL).

Abstract

Background: Hispanic/Latino adults commonly experience high psychosocial stress yet little is known about the pathways linking sociocultural stressors and asthma in this population.

Objective: Whether and how sociocultural stressors are associated with asthma in Hispanic/Latino adults.

Methods: 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.

Results: 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 (OR for < median vs ≥ median value=1.60 [95% CI=1.29, 1.99). Depressive symptoms and anxiety explained 26% and 22%, respectively, of the association between cumulative sociocultural stressors and asthma symptoms.

Conclusions: 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.