Background Ethnic differences in the prevalence of asthma, wheeze and eczema have been reported with South Asian populations having lower rates than white British adults and children. To date however the examination of multi-morbidity, which is the co-existence of all of these conditions within individuals remains largely unexplored. There is some evidence that children who have multi-morbidities are more likely to experience greater severity of symptoms and may also be likely to experience continuation of symptoms into adulthood. The evaluation of multi-morbidity in this early age group may help us to detect those children with more severe phenotypes of these conditions at an earlier age ensuring appropriate management.
Methods A subgroup of the main Born in Bradford (BiB) cohort, aged four years, were recruited for this study. This subgroup consisted of 439 White British (WB) and 836 Pakistani (P) origin children. Using standardised International Study of Asthma and Allergies in Childhood (ISAAC) questions the parents of these children were asked to report on whether their child had ever had a doctor diagnosis of asthma and eczema and whether they had had wheezing in the past 12 months. Odds ratios were calculated to determine the differences in risk between WB and P children. Models were adjusted for covariates know to influence these outcomes which included breastfeeding, parental history of asthma and eczema, mode of birth, mothers age at birth, child’s body mass index (BMI), child’s gender, birth order, parental smoking status, birth weight and maternal education as a proxy for socio-economic position.
Results There were ethnic differences in the three outcomes of interest. Doctor diagnosis of asthma was more common in children of P origin (13.5% vs 8.8%) as was parental report of wheezing in the past 12 months (22.4% vs 20.0%). Doctor diagnosis of eczema was however more common in WB children (32.1% vs 22.1%). Co-morbidity of all conditions showed little difference between ethnic groups with 4.3% of all WB children having co-morbidities versus 4.2 of P children. Adjusted analysis showed that multi-morbidity in P origin children compared to WB children was lower OR 0.8 (95% CI 0.4–1.6). Multi-morbidity was however shown to be lower in children whose mother had higher educational attainment versus lower attainment OR 0.5 (95% CI 0.3–0.9) and for girls compared to boys, OR 0.5 (95% CI 0.3–0.9).
Conclusion Despite ethnic differences in single conditions there were no statistically significant differences in multi-morbidities by ethnicity in UK born children. Higher maternal education reduced the odds of multi-morbidity implying that there may be potential causal pathways related to deprivation.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.