ASTHMA PREVALENCE DISPARITIES AMONG NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER, ASIAN, AND WHITE ADULTS IN THE UNITED STATES – SOCIAL EPIDEMIOLOGIC FINDINGS FROM THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), 2001–2010

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dc.contributor.advisorKatz, Alan R.
dc.contributor.authorJessop, Holly
dc.contributor.departmentPublic Health
dc.date.accessioned2019-05-28T20:38:12Z
dc.date.available2019-05-28T20:38:12Z
dc.date.issued2018-12
dc.identifier.urihttp://hdl.handle.net/10125/62771
dc.subjectEpidemiology
dc.subjectBiostatistics
dc.subjectDisease frequency surveys
dc.subjectDisparities in health
dc.subjectLung disease
dc.subjectOcean ancestry group
dc.subjectSocial determinants of health
dc.subjectSocioeconomic status
dc.titleASTHMA PREVALENCE DISPARITIES AMONG NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER, ASIAN, AND WHITE ADULTS IN THE UNITED STATES – SOCIAL EPIDEMIOLOGIC FINDINGS FROM THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), 2001–2010
dc.typeThesis
dcterms.abstractObjectives: Despite relatively high asthma prevalence, little is known about the epidemiology of asthma among Native Hawaiian/Other Pacific Islanders (NHOPI), or the roles of socioeconomic factors in asthma disparities among NHOPI. Methods: Multivariable logistic regression using 2001-2010 Behavioral Risk Factor Surveillance System data was conducted to provide adjusted lifetime and current asthma prevalence estimates and ratios, within groupings by sex and self-identified census categories of race for the overall US population, as well as separately for the US state of Hawai‘i. Asthma prevalence disparities by race were also investigated within groupings by sex and indicators of socioeconomic status (SES). The comparative abilities of risk factors to predict asthma within strata by race or SES were investigated using dominance analysis. Results: Asthma prevalence markedly differed between groupings by sex and race, with those self-identifying as NHOPI frequently having the highest point estimates of ever-diagnoses and current asthma. There was evidence of excess asthma in Hawai‘i compared to other US regions, especially among White women and Asians. Sociodemographic factors predictive of adult asthma prevalence varied by both sex and race. Women often had higher asthma prevalence than males of the same race, but the degree to which sex modified asthma prevalence differed by race, sociodemographic characteristic, and/or socioeconomic status. There were consistent dose-response declines in asthma prevalence with increasing SES only among Whites and women of race other than NHOPI, White, or Asian. Asthma was most frequent among NHOPI within some lower and upper levels of SES. Asthma disparities by race were modified by sex and SES; stratification by SES attenuated associations between asthma and race. However, some asthma disparities by race persisted after controlling for SES, including for NHOPI and in comparison with Asians. The dominant factors predictive of adult asthma prevalence depended on sex and race, as well as education attainment. Conclusions: The distribution of asthma in the US is not socially equitable and instead depends on race and/or SES. The findings of this work call for greater considerations in asthma studies regarding interactions between race and social factors and provide a baseline with which to plan and compare other prevention programs, epidemiological investigations, and surveillance for asthma.
dcterms.descriptionPh.D. Thesis. University of Hawaiʻi at Mānoa 2018.
dcterms.extent200 pages
dcterms.languageeng
dcterms.publisherUniversity of Hawaiʻi at Mānoa
dcterms.rightsAll UHM dissertations and theses are protected by copyright. They may be viewed from this source for any purpose, but reproduction or distribution in any format is prohibited without written permission from the copyright owner.
dcterms.typeText
local.identifier.alturihttp://dissertations.umi.com/hawii:10021

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