Place of Birth Contributes to Asthma Disparity

BOSTON (December 1, 2008) - Tufts researchers and colleagues report that place of birth plays a role in the occurrence of asthma in a United States black population. The researchers found that within one inner-city population, blacks born in the United States were more likely to have asthma than blacks who were born outside of the United States.

"Within Asian and Hispanic populations, there is research that indicates that asthma varies between those who are born in the U.S. and those who are foreign-born. There is currently no research that we found that describes asthma prevalence among black/African-American subpopulations in the U.S.," says first author Doug Brugge, PhD, associate professor in the Department of Public Health and Family Medicine at Tufts University School of Medicine in Boston.

In partnership with Tufts University School of Medicine, the Boston Urban Asthma Coalition (BUAC) implemented the project in Dorchester in response to parents who wanted to determine how asthma affects their community. Adults 18 years and older were recruited from various locations in Dorchester to participate in the oral survey. If the recruited adults had children, they answered asthma-related questions about their children. Parent leaders from BUAC and students from Harvard Medical School conducted the survey, which included questions from asthma screening questionnaires used and validated by other organizations and research studies. Questions included place of birth as well as questions related to occurrence of asthma symptoms (e.g., chest tightness, wheezing, family history of asthma, allergies, etc.) and environmental factors that would lead to asthma (e.g.,maternal smoking during pregnancy, mold growth in the home, vehicle traffic near home, etc.)

Of the 479 surveys conducted, Brugge and colleagues analyzed 290 adult and 157 child responses from individuals who self-identified as black/African-American. Thirty percent of the adults in the study born in the U.S. were diagnosed with asthma while only 11 percent of adults in the study born outside of the U.S reported asthma. Twenty-three percent (36 subjects) of children in the study born in the U.S. had been diagnosed as having asthma. None of the children born outside of the U.S. (14 subjects) had been diagnosed as having asthma. The findings were reported in the Journal of Asthma.

"This study cannot be generalized to the U.S. population because we focused on a specific neighborhood in Boston. Moreover, we did not set out to investigate place of birth, and we did not ask questions about the respondents' country of origin, if they were foreign-born," reports Brugge.

"Asthma is a community issue for Boston. Many parents are concerned because knowing that their children suffer from asthma is stressful, especially if they feel they don't have the information needed to help their children effectively," says Neal-Dra Osgood, co-author of the study and project director of the Strengthening Voices Project at BUAC. "This study helps us understand which population is hit the hardest by this chronic disorder and helps direct our community efforts."

"If future research confirms that the U.S.-born black population has a higher prevalence of asthma than the foreign-born black population, resources such as asthma screening and detection can be directed to populations or communities most in need," says Brugge.

The Baker Foundation and Tufts Medical Center Dorchester Health Initiative funded the work of Boston Urban Asthma Coalition.

The full text of the journal article will be available through December 30th, 2008, on the Journal of Asthma web site.

Brugge D, Woodin M, Schuch TJ, Salas FL, Bennett A, and Osgood N. Journal of Asthma. 2008. (November); 45(9): 785-789. "Community-Level Data Suggest That Asthma Prevalence Varies Between U.S. and Foreign-Born Black Subpopulation." Published online November 1, 2008, doi: 10.1080/02770900802179957

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