Puerto Rican children, particularly those born in Puerto Rico, bear a much higher burden of asthma than other children in the United States, concludes a study supported in part by the Agency for Healthcare Research and Quality (HS00008). Over one-fourth (26 percent) of Puerto Rican children studied were diagnosed with asthma at some point compared with 16 percent of black children, 13 percent of white children, and 10 percent of Mexican children. Similarly, 12 percent of Puerto Rican children had suffered a recent asthma attack compared with 7 percent of black children, 6 percent of white children, and 4 percent of Mexican children in the United States.
Among children born in the United States whose parents were also born in the United States, Puerto Rican children were nearly twice as likely as either Mexican children or white children to be diagnosed with asthma at some point. Yet island-born Puerto Rican children were 2.5 times more likely and Mexico-born Mexican children were 57 percent less likely to be diagnosed with asthma at some point than U.S.-born white children with U.S.-born parents, after adjusting for other factors affecting risk of asthma. All of these patterns were similar for recent asthma attacks.
The higher asthma morbidity rates among Puerto Rican children were not explained by sociodemographic and other asthma risk factors (such as household smoking) measured in the National Health Interview Survey (NHIS). An ethnic group-specific genetic predisposition among Puerto Rican children that interacts with early life physical and social environmental exposures (for example, molds and family psychosocial stressors) may contribute to their higher prevalence of asthma, notes Marielena Lara, M.D., M.P.H., of the University of California, Los Angeles. These findings were based on analysis of 1997-2001 NHIS data on the prevalence of asthma diagnosis and asthma attacks in a sample of 46,511 children (ages 2 to 17 years) living in the 50 States and Washington, D.C.
See "Heterogeneity of childhood asthma among Hispanic children: Puerto Rican children bear a disproportionate burden," by Dr. Lara, Lara Akinbami, M.D., Glenn Flores, M.D., and Hal Morgenstern, Ph.D., in the January 2006 Pediatrics 117(1), pp. 43-53.