Asthma morbidity measures across Black ethnic subgroups

Leah Ishmael, Andrea Apter, Paula J. Busse, Rafael Calderon-Candelario, Jennifer K. Carroll, Thomas Casale, Juan C. Celedón, Rubin Cohen, Tamera Coyne-Beasley, Jing Cui, Brianna Ericson, Paulina Hernandez, David C. Kaelber, Nancy Maher, Conner Merriman, Giselle Mosnaim, Sylvette Nazario, Wanda Phipatanakul, Victor Pinto-Plata, Isaretta RileyKartik Shenoy, Juan Wisnivesky, Barbara Yawn, Elliot Israel, Juan Carlos Cardet

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)408-417
Number of pages10
JournalJournal of Allergy and Clinical Immunology
Volume153
Issue number2
DOIs
StatePublished - Feb 2024

Keywords

  • African American
  • Caribbean Black
  • Continental African
  • ED visits
  • Latinx
  • asthma exacerbations
  • health care disparities
  • health care utilization
  • hospitalizations
  • minority health
  • severe persistent asthma

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