摘要：Objectives. We analyzed asthma prevalence among US adults by age, gender, race, Puerto Rican ethnicity, and other demographic, behavioral, health, and geographic variables. We hypothesized that high prevalences would be observed among Puerto Ricans and in the Northeast census region. Methods. We used data from the 1998 through 2000 US National Health Interview Surveys. Information on lifetime history of asthma and asthma in the past year was collected from 95615 adults. We calculated weighted prevalence estimates and odds ratios from logistic regression. Results. Of US adults, 8.9% had ever been diagnosed with asthma, and 3.4% had experienced an episode in the past 12 months. Asthma diagnosis rates were highest among Puerto Ricans (17.0%) and lowest among Mexican Americans (3.9%); rates were 9.6% and 9.2% among non-Hispanic Blacks and non-Hispanic Whites, respectively. Geographically, asthma prevalence was highest in the West (10.5%) and lowest in the Northeast (8.6%). Puerto Ricans in all regions had high asthma rates. Conclusions. final logistic regression model included race/ethnicity, obesity, poverty, female gender, and cigarette smoking. Higher asthma rates were confirmed among Puerto Ricans but not in the Northeast region. Most national-level studies of asthma risk factors in the United States have been limited to children, 1 , 2 and high asthma rates have been reported among Puerto Rican children living in the urban centers of the Northeast. 3 However, asthma incidence rates have increased in all age groups over the past 40 years. 4 , 5 Although the National Center for Health Statistics 6 – 9 and the Behavioral Risk Factor Surveillance System (BRFSS) 10 – 12 publish annual national estimates of asthma prevalence among US adults by age, race, and gender, to our knowledge, no studies have assessed the relevance of these factors, in combination, to asthma rates in a nationwide sample of adults. We investigated several risk factors for asthma in adults that have been described in the literature: female gender, 5 , 10 , 13 Black race, 5 , 10 , 12 Puerto Rican ethnicity, 14 , 15 obesity, 13 , 16 , 17 poverty, 10 cigarette smoking, 18 urban residence, 2 , 14 health care use, 1 , 5 and exposure to environmental tobacco smoke (ETS). 3 , 19 Environmental exposures associated with asthma include mold, cockroaches, dust mites, gas stoves, and pets, but information on these risk factors was not available in our data set. 3 , 19 Genetic factors, 20 including family health history 21 and gene–environment interactions, 22 are increasingly being included in research on asthma. A Connecticut study found a relative risk of 2.49 among children whose mothers had been diagnosed with asthma compared with children whose mothers had not been diagnosed for all race/ethnicity groups combined as well as for each group considered separately. 3 Because of the high prevalence of asthma among Puerto Ricans and the low prevalence reported among Mexican Americans, 1 the Genetics of Asthma in Latino Americans Study was initiated to investigate differences between these 2 groups in genetic susceptibility to asthma. 23 Lara et al. 24 recommended that population-based surveys, such as the National Health Interview Survey (NHIS), be used to explore the relative importance of different asthma risk factors, including ethnicity, geography, socioeconomic status, and access to health care. In this study, we implemented that recommendation. Our goal was to provide national estimates of asthma prevalence among US adults as well as to analyze the relative contributions of demographic, geographic, socioeconomic, behavioral, environmental, and health care variables to elevated rates. We hypothesized that asthma prevalence would be higher among Puerto Ricans than among other racial and ethnic subgroups, higher in the Northeast region of the United States than in other regions, and higher in urban central cities than in less urban areas.
