TY - JOUR
T1 - Asthma morbidity measures across Black ethnic subgroups
AU - Ishmael, Leah
AU - Apter, Andrea
AU - Busse, Paula J.
AU - Calderon-Candelario, Rafael
AU - Carroll, Jennifer K.
AU - Casale, Thomas
AU - Celedón, Juan C.
AU - Cohen, Rubin
AU - Coyne-Beasley, Tamera
AU - Cui, Jing
AU - Ericson, Brianna
AU - Hernandez, Paulina
AU - Kaelber, David C.
AU - Maher, Nancy
AU - Merriman, Conner
AU - Mosnaim, Giselle
AU - Nazario, Sylvette
AU - Phipatanakul, Wanda
AU - Pinto-Plata, Victor
AU - Riley, Isaretta
AU - Shenoy, Kartik
AU - Wisnivesky, Juan
AU - Yawn, Barbara
AU - Israel, Elliot
AU - Cardet, Juan Carlos
N1 - Publisher Copyright:
© 2023 American Academy of Allergy, Asthma & Immunology
PY - 2024/2
Y1 - 2024/2
N2 - Background: Black adults are disproportionately affected by asthma and are often considered a homogeneous group in research studies despite cultural and ancestral differences. Objective: We sought to determine if asthma morbidity differs across adults in Black ethnic subgroups. Methods: Adults with moderate-severe asthma were recruited across the continental United States and Puerto Rico for the PREPARE (PeRson EmPowered Asthma RElief) trial. Using self-identifications, we categorized multiethnic Black (ME/B) participants (n = 226) as Black Latinx participants (n = 146) or Caribbean, continental African, or other Black participants (n = 80). African American (AA/B) participants (n = 518) were categorized as Black participants who identified their ethnicity as being American. Baseline characteristics and retrospective asthma morbidity measures (self-reported exacerbations requiring systemic corticosteroids [SCs], emergency department/urgent care [ED/UC] visits, hospitalizations) were compared across subgroups using multivariable regression. Results: Compared with AA/B participants, ME/B participants were more likely to be younger, residing in the US Northeast, and Spanish speaking and to have lower body mass index, health literacy, and <1 comorbidity, but higher blood eosinophil counts. In a multivariable analysis, ME/B participants were significantly more likely to have ED/UC visits (incidence rate ratio [IRR] = 1.34, 95% CI = 1.04-1.72) and SC use (IRR = 1.27, 95% CI = 1.00-1.62) for asthma than AA/B participants. Of the ME/B subgroups, Puerto Rican Black Latinx participants (n = 120) were significantly more likely to have ED/UC visits (IRR = 1.64, 95% CI = 1.22-2.21) and SC use for asthma (IRR = 1.43, 95% CI = 1.06-1.92) than AA/B participants. There were no significant differences in hospitalizations for asthma among subgroups. Conclusions: ME/B adults, specifically Puerto Rican Black Latinx adults, have higher risk of ED/UC visits and SC use for asthma than other Black subgroups.
AB - Background: Black adults are disproportionately affected by asthma and are often considered a homogeneous group in research studies despite cultural and ancestral differences. Objective: We sought to determine if asthma morbidity differs across adults in Black ethnic subgroups. Methods: Adults with moderate-severe asthma were recruited across the continental United States and Puerto Rico for the PREPARE (PeRson EmPowered Asthma RElief) trial. Using self-identifications, we categorized multiethnic Black (ME/B) participants (n = 226) as Black Latinx participants (n = 146) or Caribbean, continental African, or other Black participants (n = 80). African American (AA/B) participants (n = 518) were categorized as Black participants who identified their ethnicity as being American. Baseline characteristics and retrospective asthma morbidity measures (self-reported exacerbations requiring systemic corticosteroids [SCs], emergency department/urgent care [ED/UC] visits, hospitalizations) were compared across subgroups using multivariable regression. Results: Compared with AA/B participants, ME/B participants were more likely to be younger, residing in the US Northeast, and Spanish speaking and to have lower body mass index, health literacy, and <1 comorbidity, but higher blood eosinophil counts. In a multivariable analysis, ME/B participants were significantly more likely to have ED/UC visits (incidence rate ratio [IRR] = 1.34, 95% CI = 1.04-1.72) and SC use (IRR = 1.27, 95% CI = 1.00-1.62) for asthma than AA/B participants. Of the ME/B subgroups, Puerto Rican Black Latinx participants (n = 120) were significantly more likely to have ED/UC visits (IRR = 1.64, 95% CI = 1.22-2.21) and SC use for asthma (IRR = 1.43, 95% CI = 1.06-1.92) than AA/B participants. There were no significant differences in hospitalizations for asthma among subgroups. Conclusions: ME/B adults, specifically Puerto Rican Black Latinx adults, have higher risk of ED/UC visits and SC use for asthma than other Black subgroups.
KW - African American
KW - Caribbean Black
KW - Continental African
KW - ED visits
KW - Latinx
KW - asthma exacerbations
KW - health care disparities
KW - health care utilization
KW - hospitalizations
KW - minority health
KW - severe persistent asthma
UR - http://www.scopus.com/inward/record.url?scp=85180512157&partnerID=8YFLogxK
U2 - 10.1016/j.jaci.2023.10.028
DO - 10.1016/j.jaci.2023.10.028
M3 - Article
C2 - 38000696
AN - SCOPUS:85180512157
SN - 0091-6749
VL - 153
SP - 408
EP - 417
JO - Journal of Allergy and Clinical Immunology
JF - Journal of Allergy and Clinical Immunology
IS - 2
ER -