Race/ethnic differences in respiratory problems among a nationally-representative cohort of young children in the United States

Abstract

Using data from a nationally-representative cohort of young children in the United States, we ask the following: (1) Are there race/ethnic and birth weight differentials in the likelihood of developing respiratory problems by age three in a nationally representative birth cohort? (2) To what extent does birth weight, vis-á-vis other key sociodemographic risk factors, mediate race/ethnic differentials in reported respiratory problems? (3) Does the effect of birth weight on respiratory problems risk differ by race? We find that non-Hispanic black children are 1.7 times as likely as non-Hispanic white children to be reported to have respiratory problems by age three, while the risk for Hispanic children is similar to that of non-Hispanic white children. Birth weight is also very strongly related to respiratory problem risk. Specifically, children born at very low weights (500–1499 g) have four times the odds of having respiratory problems of heavier children. Statistical controls for birth weight decrease the black-white differential by about 20%, while additional controls for sociodemographic factors reduce the race differential by an additional 35%. Finally, the net effect of birth weight is different for black and white children: whereas birth weight affects the risk of respiratory problems for black children only at low weights (<1500 g), it remains an important predictor of excess risk for white children up to 3500 g.