The Burden and Social Determinants of Asthma Among Children in the State of Georgia

  • Mark H. EbellEmail author
  • Christian Marchello
  • Lu Meng
  • Jean O’Connor
Original Paper


Asthma is one of the most common chronic health conditions in children, and social determinants are thought to be important risk factors. We used Georgia data from the Behavioral Risk Factors Surveillance Survey (BRFSS), and data from the Georgia hospital and emergency department survey for children with a diagnosis of asthma. All data were from the years 2011 to 2016. SAS and SUDAAN were used to calculate weighted prevalence estimates and to perform univariate and multivariate analysis of the association between social determinants, demographic characteristics, other potential risk factors, and asthma-related outcomes. The prevalence of asthma is higher in African-American children and when the parental income is less than $75,000 per year. A multivariate analysis adjusting for ethnicity, parental income, and sex found that the strongest independent predictor of asthma was African-American race (aOR 2.9, 95% CI 1.5–5.8). African-American and multiracial children also experienced extremely high burdens due to asthma related hospitalizations and emergency department visits, with rates two to five times higher than children in other groups. The secular trend for ED visits and hospitalizations is declining. African-American race is an independent predictor of asthma in children in Georgia, and African-American and multiracial children experience a greater burden of asthma than children of other races. Programmatic efforts at the state and national level to improve access, adherence, and knowledge about asthma are important if we are to continue to improve outcomes for these children.


Asthma Prevalence Social determinants Adults Socioeconomic 



The authors would like to thank the staff of the Georgia Department of Public Health for their assistance accessing deidentified data for this study.


This study was funded by a subcontract to the University of Georgia for epidemiologic support of asthma control efforts, as part of CDC-funded activities at the Department of Public Health, including Cooperative Agreement numbers U59EH000520 and 5U580000021-03.

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Mark H. Ebell
    • 1
    Email author
  • Christian Marchello
    • 2
  • Lu Meng
    • 3
  • Jean O’Connor
    • 4
  1. 1.Department of Epidemiology, College of Public HealthUniversity of GeorgiaAthensUSA
  2. 2.Department of Preventive and Social MedicineUniversity of OtagoDunedinNew Zealand
  3. 3.Georgia Department of Public HealthAtlantaUSA
  4. 4.Center for Affordable Medical InnovationEmory UniversityAtlantaUSA

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