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Contribution of weight status to asthma prevalence racial disparities, 2-19 year olds, 1988-2014.

ABSTRACT: PURPOSE:Racial disparities in childhood asthma prevalence increased after the 1990s. Obesity, which also varies by race/ethnicity, is an asthma risk factor but its contribution to asthma prevalence disparities is unknown. METHODS:We analyzed nationally representative National Health Examination and Nutrition Survey data for 2-19 year olds with logistic regression and decomposition analyses to assess the contributions of weight status to racial disparities in asthma prevalence, controlling for sex, age, and income status. RESULTS:From 1988-1994 to 2011-2014, asthma prevalence increased more among non-Hispanic black (NHB) (8.4% to 18.0%) than non-Hispanic white (NHW) youth (7.2% to 10.3%). Logistic regression showed that obesity was an asthma risk factor for all groups but that a three-way "weight status-race/ethnicity-time" interaction was not significant. That is, weight status did not modify the race/ethnicity association with asthma over time. In decomposition analyses, weight status had a small contribution to NHB/NHW asthma prevalence disparities but most of the disparity remained unexplained by weight status or other asthma risk factors (sex, age and income status). CONCLUSIONS:NHB youth had a greater asthma prevalence increase from 1988-1994 to 2011-2014 than NHW youth. Most of the racial disparity in asthma prevalence remained unexplained after considering weight status and other characteristics.

SUBMITTER: Akinbami LJ

PROVIDER: S-EPMC6413506 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

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Contribution of weight status to asthma prevalence racial disparities, 2-19 year olds, 1988-2014.

Akinbami Lara J LJ Rossen Lauren M LM Fakhouri Tala H I THI Simon Alan E AE Kit Brian K BK

Annals of epidemiology 20170714 8

<h4>Purpose</h4>Racial disparities in childhood asthma prevalence increased after the 1990s. Obesity, which also varies by race/ethnicity, is an asthma risk factor but its contribution to asthma prevalence disparities is unknown.<h4>Methods</h4>We analyzed nationally representative National Health Examination and Nutrition Survey data for 2-19 year olds with logistic regression and decomposition analyses to assess the contributions of weight status to racial disparities in asthma prevalence, con ...[more]

PMID: 28778655

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Project description:BACKGROUND:After the promotion of the two-child policy in recent years, the population of children in mainland China was bound to have a rapid growth, which would bring great challenges to public health. A number of cross-sectional studies on the epidemic of childhood asthma in mainland China were recently conducted, and varied prevalences were reported. Thus, knowing the epidemiology of childhood asthma in mainland China is of great necessity. OBJECTIVE:Our study aimed to summarize the pooled prevalence of childhood asthma in mainland China and its time trend, gender difference, regional distribution, and age structure. METHODS:Studies that reported the prevalence of childhood asthma in mainland China were identified via a systematic data base search through July 1, 2016. Meta-analysis was used to estimate the prevalence of childhood asthma and its subgroups, including gender, age groups, years, and regions. The regional distribution of the prevalence was set by province with the help of a geographic mapping software. The autoregressive integrated moving average model was used to predict the current prevalence of asthma. RESULTS:A total of 117 studies published from 1988 to 2014 in mainland China with a total sample size of 2,678,696 were included. The overall current prevalence and lifetime prevalence of childhood asthma was 2.112% (95% confidence interval [CI], 1.977-2.247%) and 2.502% (95% CI, 2.166-2.838%), respectively. The difference of the prevalences between male and female patients was significant: odds ratio 1.54 (95% CI, 1.47-1.62) for the current prevalence and odds ratio 1.61 (95% CI, 1.47-1.77) for the lifetime prevalence. CONCLUSION:The prevalence of childhood asthma in mainland China was low but has been increasing remarkably since 1998. Boys are more likely to have asthma throughout most of their childhood. Preschoolers (3-6 years old) showed a higher prevalence than the other age groups. The current prevalence of childhood asthma probably increased slightly from 2017 to 2019.

Project description:Background:Racial disparities in cancer have been attributed to population differences in access to care. Differences in cancer overdiagnosis rates are another, less commonly considered cause of disparities. Here, we examine the contribution of overdiagnosis to observed racial disparities in papillary thyroid cancer and estrogen/progesterone receptor positive (ER/PR+) breast cancer. Methods:We used Surveillance, Epidemiology, End-Results (SEER) 13 for analysis of white and black non-Hispanic persons with papillary thyroid cancer or ER/PR+ breast cancer (1992-2014). Analyses were performed using SeerStat (v8.3.5, March 2018). All statistical tests were two-sided. Results:White persons had higher incidence of papillary thyroid cancer than black persons (14.3 vs 7.7 cases per 100?000 age-adjusted population) and ER/PR+ breast cancer (94.8 vs 70.9 cases per 100?000 age-adjusted population) (P < .001). In papillary thyroid cancer, the entire incidence difference was from more frequent diagnosis of 2-cm or less (10.0 vs 4.9 cases per 100?000 population) and localized or regional (13.8 vs 7.4 cases per 100?000 population) cancers in white persons (P < .001), without corresponding excess of metastatic disease, cancers greater than 4 cm, or incidence-based mortality in black persons. In women with ER/PR+ breast cancer, 95% of the incidence difference was from more 2-cm or less (61.2 vs 38.1 cases per 100?000 population) or 2.1- to 5-cm (25.4 vs 23.4 cases per 100?000 population), localized (65.1 vs 43.0 cases per 100?000 population) cancers diagnosed in white women (P < .001), with slightly higher incidence of tumors greater than 5 cm (10.1 vs 9.3 cases per 100?000 population, P < .001) and incidence-based mortality (8.1 vs 7.2 cases per 100?000 population, P < .001) among black women. Overall, 20-30 additional small or localized ER/PR+ breast cancers were diagnosed in white compared with black women for every large or advanced tumor avoided by early detection. Overdiagnosis was estimated 1.3-2.5 times (papillary thyroid cancer) and 1.7-5.7 times (ER/PR+ breast cancer) higher in white compared with black populations. Conclusions:Differences in low-risk cancer identification among populations lead to overestimation of racial disparities. Estimates of overdiagnosed cases should be considered to improve care and eliminate disparities while minimizing harms of overdiagnosis.

Dataset Information

Contribution of weight status to asthma prevalence racial disparities, 2-19 year olds, 1988-2014.

Publications

Contribution of weight status to asthma prevalence racial disparities, 2-19 year olds, 1988-2014.

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