Ethnicity and Risk of Hospitalization for Asthma and Chronic Obstructive Pulmonary Disease

• Published in: Annals of epidemiology Vol. 21; no. 8; pp. 615 - 622
• Main Authors: Tran, H. Nicole, MD, Siu, Stanton, MD, Iribarren, Carlos, MPH, MD, PhD, Udaltsova, Natalia, PhD, Klatsky, Arthur L., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2011
• Subjects: Age Factors; Alcohol Drinking; Asian Americans; Asian People - statistics & numerical data; Asthma; Asthma - epidemiology; Asthma - ethnology; Asthma - therapy; Black or African American; Black People - statistics & numerical data; Body Mass Index; California - epidemiology; Chronic Obstructive Pulmonary Disease; Cohort Studies; Educational Status; Epidemiology; Ethnic Groups; Female; Hispanic or Latino - statistics & numerical data; Hospitalization - statistics & numerical data; Humans; Internal Medicine; Male; Middle Aged; Pulmonary Disease, Chronic Obstructive - epidemiology; Pulmonary Disease, Chronic Obstructive - ethnology; Pulmonary Disease, Chronic Obstructive - therapy; Risk; Risk Factors; Sex Factors; White People - statistics & numerical data; California; RR; International Classification of Diseases, Ninth Revision, Clinical Modification; Risk; ICD – 9 – CM; Alcohol Drinking; Epidemiology; Ethnic Groups; BMI; pack per day; ppd; body mass index; CI; relative risk; Asthma; CR; crude rate; AAT; principal investigator; α 1–antitrypsin; PI; Chronic Obstructive Pulmonary Disease; confidence interval; Asian Americans; Cohort Studies; COPD
• ISSN: 1047-2797; 1873-2585; 1873-2585
• DOI: 10.1016/j.annepidem.2010.10.015

Purpose To identify ethnic differences for risk of hospitalization for asthma and chronic obstructive pulmonary disease (COPD). Methods We undertook a cohort study with 126,019 participants: 55% whites, 27% blacks, 11% Asians, and 4% Hispanics. To estimate asthma and COPD risk, we used Cox proportional hazards models adjusted for age, sex, body mass index, education, smoking, and alcohol intake. End points were hospitalizations for asthma or COPD. Results Compared with whites, relative risks (RR) with 95% confidence intervals (95% CI) for asthma among other groups were: blacks, 1.7 (1.4–2.0); Hispanics, 0.9 (0.6–1.4); and Asians, 1.6 (1.2–2.1). Among Asians, increased risk was concentrated in Filipino men and women and South Asian men. For COPD, whites were at highest risk; RR of blacks was 0.9 (0.7–1.0); Hispanics, 0.6 (0.3– 0.9); and Asians, 0.4 (0.3–0.6). COPD risk among Asians was lowest in Chinese with RR of 0.3 (0.1–0.5). Conclusions Ethnic disparities in risk of asthma and COPD as well as between both diseases exist, especially for Asian Americans, who have high asthma risk and low COPD risk. While residual confounding for smoking or other environmental factors could be partially responsible, genetic factors in Asians may be involved in decreased COPD risk.