Asthma among minority children. A growing problem.

sthma is a growing problem among all children, but it is greatest among minority children. The second National Health and Nutrition Examination Survey (NHANES II)’ of the National Center for Health Statistics found that asthma prevalence rates are significantly higher for black than for white children and for boys than for girls, regardless of whether the definition is (1) ever having asthma diagnosed by a physician, (2) currently having asthma diagnosed by a physician, (3) wheezing within the past 12 months, (4) ever having been diagnosed with asthma plus wheezing, or (5) currently diagnosed with asthma plus wheezing. Fewer data are available for Hispanic than for black subjects, partly because Hispanics have traditionally been included in the white population. The NIAID National Cooperative Inner-City Asthma Study in progress should provide a better measure of the problem in Hispanic children, but we have reason to believe that asthma is also a greater problem for Hispanic than for white persons. Hospital discharge rates and mortality data indicate that minority children are also experiencing more severe asthma. For example, in 1965, the discharge rate for asthma among children up to 14 years old was 48 per 100,000 population. By 1983, discharge rates had escalated to 166 per 100,000, and rates for nonwhite children were approximately twice the rates for white children. At Children’s Memorial Hospital in Chicago, hospitalizations for childhood asthma have increased by 6% per year since 1985. On average, the hospital admits at least 5 children per day for asthma; the asthma admission rate is greater than that for any other common medical condition. Over one half of the asthma admissions are black and Hispanic children, and the proportion of these minorities is increasing, while that for white subjects is declining. Black and Hispanic children are about evenly represented, but more boys are admitted than girls. Age-specific death rates for asthma in children are about the same for boys and girls, but the death rate is 0.7 per 100,000 population in black 5to 14-year-old children, while it is only 0.1 in white children in the same age group. The death rate for asthmatic children in Chicago and Cook County is among the highest in the nation.4 Between 1982 and 1985, Cook County had an average annual mortality of 6.6 deaths per 100,000 population compared to the national average of 3.5 deaths per 100,000 population. Other areas of excess mortality include New York City Maricopa County, Arizona, and Fresno County, California.