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Race/Ethnicity, Income, Chronic Asthma, and Mental Health: A Cross-Sectional Study Using the Behavioral Risk Factor Surveillance System

From the Departments of Epidemiology and Biostatistics (F.C.B., N.A.) and Clinical and Health Psychology (D.B.P.), College of Public Health and Health Professions, University of Florida, Gainesville, Florida; Department of Public Health Sciences (A.A.A.), University of North Carolina at Charlotte, North Carolina; and the Center for Sexual Health Promotion (B.D.), Department of Applied Health Science, Indiana University, Bloomington, Indiana.

Address correspondence and reprint requests to Deidre B. Pereira, Department of Clinical and Health Psychology, University of Florida College of Public Health and Health Professions, P. O. Box 100165, Gainesville, FL 32610-0165. E-mail: dpereira{at}phhp.ufl.edu

Objective: To examine the relationships among race/ethnicity, income, and asthma on mental health outcomes in individuals surveyed as part of the Centers for Disease Control and Prevention 2004 Behavioral Risk Factor Surveillance System (BRFSS). Racial and ethnic disparities in asthma prevalence exist, which may be explained in part by socioeconomic status. Individuals with asthma often have comorbid mental health conditions, the rates of which are also marked by significant racial and ethnic disparities.

Methods: We obtained 2004 BRFSS demographic, asthma, and mental health data on Hispanics, non-Hispanic Whites, and non-Hispanic Blacks. Linear regression analysis was used to examine the main and interaction effects of race/ethnicity, income, and history of asthma on poor mental health (n = 282,011), as well as on depression (n = 14,907) and anxiety (n = 14,871) specifically.

Results: A significant three-way interaction emerged among race/ethnicity, income, and history of chronic asthma on number of days of poor mental health. Among the most impoverished (income <$15,000/yr), Hispanics with asthma reported greater number of days of poor mental health than non-Hispanic Whites with asthma. However, among those with slightly greater economic resources, Hispanics with asthma reported fewer number of days of poor mental health than non-Hispanic Whites.

Conclusions: The results of this study highlight the complex interactions among race/ethnicity, income, and asthma on mental health outcomes.

Key Words: asthma • income • racial minorities • ethnic minorities • mental health

Abbreviations: BRFSS = Behavioral Risk Factor Surveillance System.

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