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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2006.092239v1 97/7/1290    most recent Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Martin, M. A. Articles by Berry, C. A. Search for Related Content PubMed PubMed Citation Articles by Martin, M. A. Articles by Berry, C. A. Related Collections Other Child and Adolescent Health Asthma Hispanics/Latinos

Molly A. Martin, MD, MAPP, Madeleine U. Shalowitz, MD, MBA, Tod Mijanovich, MPA, Elizabeth Clark-Kauffman, MHS, Elizabeth Perez, BA and Carolyn A. Berry, PhD

Molly A. Martin is with the Departments of Preventive Medicine and Pediatrics, Rush University Medical Center, Chicago, Ill. Madeleine U. Shalowitz, Elizabeth Clark-Kauffman, and Elizabeth Perez are with the Department of Child and Family Health Studies, Evanston Northwestern Healthcare, Evanston, Ill. Tod Mijanovich and Carolyn A. Berry are with the Center for Health and Public Service Research, Robert F. Wagner Graduate School of Public Service, New York University, New York, NY.

Correspondence: Requests for reprints should be sent to Molly A. Martin, MD, MAPP, Rush University Medical Center, 1700 W Van Buren St, Suite 470, Chicago, IL 60612 (e-mail: molly_a_martin{at}rush.edu).

Objectives. We sought to determine whether low acculturation among Mexican American caregivers protects their children against asthma.

Methods. Data were obtained from an observational study of urban pediatric asthma. Dependent variables were children’s diagnosed asthma and total (diagnosed plus possible) asthma. Regression models were controlled for caregivers’ level of acculturation, education, marital status, depression, life stress, and social support and children’s insurance.

Results. Caregivers’ level of acculturation was associated with children’s diagnosed asthma (P = .025) and total asthma (P = .078) in bivariate analyses. In multivariate models, protective effects of caregivers’ level of acculturation were mediated by the other covariates. Independent predictors of increased diagnosed asthma included caregivers’ life stress (odds ratio [OR] = 1.12, P= .005) and children’s insurance, both public (OR = 4.71, P= .009) and private (OR = 2.87, P= .071). Only caregiver’s life stress predicted increased total asthma (OR = 1.21, P= .001).

Conclusions. The protective effect of caregivers’ level of acculturation on diagnosed and total asthma for Mexican American children was mediated by social factors, especially caregivers’ life stress. Among acculturation measures, foreign birth was more predictive of disease status than was language use or years in country. Increased acculturation among immigrant groups does not appear to lead to greater asthma risk.