Ethnic differences in adolescent lung function: anthropometric, socioeconomic and psychosocial factors

Copyright © 2008 American Thoracic SocietyObjectives: To examine ethnic differences in lung function in relation to anthropometry and social and psychosocial factors in early adolescence. Methods: The subjects of this study were 3,924 pupils aged 11 to 13 years, of whom 80% were ethnic minorities with satisfactory lung function measures. Data were collected on economic disadvantage, psychological well-being, tobacco exposure, height, FEV1, and FVC. Measurements and Main Results: The lowest FEV1 was observed for Black Caribbean/African children after adjusting for standing height (SH) (white boys: 2.475 L; 95% confidence interval [CI], 2.442–2.509; white girls: 2.449 L; 95% CI, 2.464–2.535]; Black Caribbean boys: –14% [95% CI, –16 to –12]; Black Caribbean girls: –13% [95% CI, –16 to –11]; Black African boys: –15% [95% CI, –17 to –13]; Black African girls: –17% [95% CI, –19 to –14]; Indian boys: –13% [95% CI, –16 to –11]; Indian girls: –11% [95% CI, –14 to –8]; Pakistani/Bangladeshi boys: –7% [95% CI, –9 to –5]; Pakistani/Bangladeshi girls: –9% [95% CI, –11 to –6]). Adjustment for upper body segment instead of SH achieved a further reduction in ethnic differences of 41 to 51% for children of Black African origin and 26 to 39% for the other groups. Overcrowding (boys) and poor psychological well-being (boys and girls) were independent correlates of FEV1, explaining up to a further 10% of ethnic differences. Similar patterns were observed for FVC. Social exposures were also related to height components. Conclusions: Differences in upper body segment explained more of the ethnic differences in lung function than SH, particularly among Black Caribbeans/African subjects. Social correlates had a smaller but significant impact. Future research needs to consider how differential development of lung capacity is compromised by the social patterning of growth trajectories.Melissa J. Whitrow and Seeromanie Hardin