Variations in asthma hospitalizations and deaths in New York City.

Abstract

BACKGROUND. Recent reports have identified New York City as having asthma mortality rates that are substantially higher than expected based on US rates. This study investigates the problems of asthma morbidity and mortality in New York City. METHODS. Data on asthma hospitalizations (1982 to 1986) and deaths (1982 to 1987) among persons aged 0 to 34 years were studied. Descriptive and multivariate techniques were used to examine differences in rates among subgroups and across geographic areas. RESULTS. The average annual hospitalization rate was 39.2 per 10,000; the mortality rate was 1.2 per 100,000. Hospitalization and death rates among Blacks and Hispanics were 3 to 5.5 times those of Whites. Large geographic variations in hospitalizations and mortality occurred. Asthma hospitalization and mortality rates were highly correlated (r = .67), with the highest rates concentrated in the city's poorest neighborhoods. Household income, percentage of population Black, and percentage of population Hispanic were significant predictors of area hospitalization rates (adjusted R2 = .75). CONCLUSION. These findings provide a basis for focusing investigations of the causes of variations in asthma outcomes and targeting interventions to reduce the disproportionate morbidity and mortality borne by poor and minority populations.

The effects of race/ethnicity and income on early childhood asthma prevalence and health care use

“…1,2 Many clinical or area studies have reported substantially higher rates of asthma prevalence, [3][4][5] hospitalization, [6][7][8][9] and mortality among Black than White persons. 8,10,11 Because asthma is most common among low-socioeconomic status groups 12 and Black persons are more likely than White persons to be poor, 13 an important question is the extent to which racial/ethnic differences in asthma are due to poverty. 6,11,14 However, many studies of asthma prevalence and health care use do not include family-level indicators of socioeconomic status (SES) or individual-level risk factors.…”

Distribution and determinants of mouse allergen exposure in low-income New York City apartments.

“…In addition, several studies have shown that low-income urban areas have a disproportionate prevalence of childhood asthma (Carr et al 1992;Litonjua et al 1999). Several investigators have seen an association between asthma and sensitization to another common urban pest, cockroaches (Call et al 1992;Gelber et al 1993), and high exposure (Bla g 1 > 8 U/g) among those sensitized has been reported as a risk factor for asthma medication use and number of asthma-related hospitalizations (Rosenstreich et al 1997).…”

The Seattle-King County healthy homes project: implementation of a comprehensive approach to improving indoor environmental quality for low-income children with asthma.

“…In the United States, low-income people and people of color are disproportionately affected by asthma. Relative to wealthier and White populations, they have higher asthma prevalence (5,(29)(30)(31) and experience more severe impacts (32)(33)(34)(35)(36)(37)(38)(39). In King County in the State of Washington, the asthma hospitalization rate of children living in high-poverty areas is three times that of those living in low-poverty areas (40).…”