Simon Paul A, Zeng Zhiwei, Wold Cheryl M, Haddock William, Fielding Jonathan E
Los Angeles County Department of Health Services, Los Angeles, California 90012, USA.
J Asthma. 2003;40(5):535-43. doi: 10.1081/jas-120018788.
Racial/ethnic and socioeconomic disparities in the prevalence of childhood asthma have been reported nationally but few population-based studies in local and regional settings have been reported. To assess variation in the prevalence of childhood asthma and associated morbidity across race/ethnic and income groups in the Los Angeles County population, we analyzed data on a random sample of 6004 children (< or = 17 years old) enrolled in a countywide health survey from September 1999 through April 2000. The prevalence of childhood asthma was highest in blacks (15.8%), intermediate in whites (7.3%) and Asians (6.0%), and lowest in Latinos (3.9%; p < 0.001). These differences persisted after controlling for income, measures of health care access, and other covariates. Asthma prevalence was inversely related to income in all racial/ethnic groups except Latinos from Spanish-speaking households. Among children with asthma, blacks and Latinos were more likely than whites to report asthma-related limitations in physical activity and need for urgent medical services. These findings indicate marked disparities in asthma prevalence and related morbidity in this large urban child population and highlight the importance of efforts to identify high-risk subpopulations for focused prevention and treatment interventions.
全国范围内都报道了儿童哮喘患病率存在种族/族裔和社会经济差异，但在地方和区域层面基于人群的研究报道较少。为评估洛杉矶县人群中不同种族/族裔和收入群体的儿童哮喘患病率及相关发病率的差异，我们分析了1999年9月至2000年4月在全县健康调查中随机抽取的6004名儿童（≤17岁）的数据。儿童哮喘患病率在黑人中最高（15.8%），在白人和亚洲人中居中（分别为7.3%和6.0%），在拉丁裔中最低（3.9%；p<0.001）。在控制了收入、医疗保健可及性指标及其他协变量后，这些差异依然存在。除了来自讲西班牙语家庭的拉丁裔外，在所有种族/族裔群体中，哮喘患病率与收入呈负相关。在患有哮喘的儿童中，黑人和拉丁裔比白人更有可能报告与哮喘相关的身体活动受限以及需要紧急医疗服务。这些发现表明，在这个庞大的城市儿童群体中，哮喘患病率及相关发病率存在显著差异，并突出了识别高危亚人群以进行重点预防和治疗干预措施的重要性。
