Asthma health disparities among Native Hawaiians and other Pacific Islander adults of the United States, 2001-2009

Abstract

Elimination of health disparities is a public health priority. Asthma is a serious and often debilitating health condition, with well-documented racial disparities in prevalence. Because asthma is a substantial health problem, with markedly increasing prevalence and mortality rates, there is an urgent need to adequately characterize asthma in high-risk populations such as Native Hawaiians and other Pacific Islanders (NHOPI) who may be disproportionately affected. However, little is known about the burden of asthma in NHOPI compared to other races in the United States (U.S.). This study is an investigation of the prevalence of asthma amongst NHOPI within the U.S., using nine years of data (2001-2009) from complete telephone survey responses of the Behavioral Risk Factor Surveillance System. Crude lifetime weighted asthma prevalence was significantly greater in NHOPI (17.22%; 95% confidence interval [CI]: 15.36, 19.25%) than in Whites (12.49%; 95% CI: 12.40%, 12.57%), and the NHOPI asthma prevalence point estimates were higher than in Whites in all age, sex, education, health care coverage, smoking status, body mass index, place of residence (Hawaiʻi vs. Mainland U.S.), and time period strata examined. Regardless of race, younger age (especially 18-24 years), female sex, education attainment less than a college degree, smoking, overweight/obese body mass index, residence in the State of Hawaiʻi, and later time periods (i.e., 2004-2006 and 2007-2009 vs. 2001-2003) were all independently associated with asthma. After controlling for these socio-demographic, geographic, and temporal factors, NHOPI odds of asthma remained significantly greater than for Whites (odds ratio [OR] 1.33; 95% CI: 1.16, 153). While adjusted odds of asthma increased with time overall (1.16; 95% CI: 1.14, 1.18 for 2007-2009 vs. 2001-2003), adjusted odds of asthma