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ICD Code: 493. Asthma

ICD Code: 493. Article Review
Title: Rose D et al; "Asthma Prevalence Among US Adults, 1998-2000: Role of Puerto Rican Ethnicity and Behavioral and Geographic Factors." American Journal of Public Health; V.96; No.5; 5/06; p880
      STUDY DESIGN: This study provided national estimates of asthma prevalence among U.S. adults and analyzed the relative contributions of demographic, geographic, socioeconomic, behavioral, environmental, and health care variables to elevated rates. The National Health Interview Survey (NHIS) is an annual national health survey in which personal interviews are conducted in respondents' homes throughout the year. This study used data collected during the 1998 through 2000 survey years. Between 1997 and 2000, the NHIS included at least 2 questions on asthma each year: "Have you ever been told by a doctor or other health professional that you had…asthma?" (lifetime asthma) and "During the past 12 months, have you had an episode of asthma or asthma attack?" (asthma in the past year).
      DIAGNOSED PREVALENCE: Between 1998 and 2000, 8.9% of adults in the civilian, noninstitutionalized population of the U.S. reported having ever been diagnosed with asthma. Lifetime asthma prevalence did not increase consistently over this 3-year period.
      RACE/ETHNICITY: The prevalence of lifetime asthma and of asthma in the past year (respectively) were reported as follows: all, 8.9%, 3.4%; non-Hispanic blacks, 9.6%, 3.6%; non-Hispanic whites, 9.2%, 3.5%; Hispanics, 7.2%, 2.9% (Puerto Ricans, 17.0%, 9.2%; Mexican Americans, 7.5%, 3.0%; Mexicans, 3.9%, 1.3%).
      OTHER RISK FACTORS: Significant risk factors in the adjusted analysis with odds ratios (ORs) included age (18-44 years versus 65 or above; OR, 1.60), obesity (versus normal weight; OR, 1.57), living below the poverty level (versus living at 200% of the poverty level or above; OR, 1.43), living in the West region (versus the Northeast; OR, 1.33), female gender (OR, 1.32), having no high school diploma (versus having a college degree or above; OR, 1.21), being a former (OR, 1.25) or current (OR, 1.18) cigarette smoker (versus never having smoked), and being a former drinker (versus a nondrinker; OR, 1.20). All of these relationships were significant.
      DISCUSSION: The results of this study confirm the hypothesis of very high asthma prevalences among Puerto Ricans compared with other racial/ethnic groups. The present authors' results confirm preliminary finding that when poverty was included in the analysis, black adults did not have significantly more asthma than did white adults. In addition, poverty (OR, 1,43) was a more important risk factor than lack of education (OR, 1.21). The results confirm that obesity and cigarette smoking are significant asthma risk factors among adults.
      The authors note that the term "Hispanics" is too general to use in studying asthma in different population groups. When a study includes geographic variables, respondents should be selected from more than one region. Even if genetic material cannot be collected, surveys should include questions on parents' asthma diagnoses.

Search Criteria: Text - American Journal of Public Health; V.96; No.5; 5/06; p880