Variations in asthma hospitalizations and deaths in New York City.
W Carr,
L Zeitel and
K Weiss
United Hospital Fund of New York, NY.
BACKGROUND. Recent reports have identified New York City ashaving asthma mortality rates that are substantially higherthan expected based on US rates. This study investigates theproblems of asthma morbidity and mortality in New York City.METHODS. Data on asthma hospitalizations (1982 to 1986) anddeaths (1982 to 1987) among persons aged 0 to 34 years werestudied. Descriptive and multivariate techniques were used toexamine differences in rates among subgroups and across geographicareas. RESULTS. The average annual hospitalization rate was39.2 per 10,000; the mortality rate was 1.2 per 100,000. Hospitalizationand death rates among Blacks and Hispanics were 3 to 5.5 timesthose of Whites. Large geographic variations in hospitalizationsand mortality occurred. Asthma hospitalization and mortalityrates were highly correlated (r = .67), with the highest ratesconcentrated in the city's poorest neighborhoods. Householdincome, percentage of population Black, and percentage of populationHispanic were significant predictors of area hospitalizationrates (adjusted R2 = .75). CONCLUSION. These findings providea basis for focusing investigations of the causes of variationsin asthma outcomes and targeting interventions to reduce thedisproportionate morbidity and mortality borne by poor and minoritypopulations.
This article has been cited by other articles:
M. Fagnano, E. van Wijngaarden, H. V. Connolly, M. A. Carno, E. Forbes-Jones, and J. S. Halterman Sleep-Disordered Breathing and Behaviors of Inner-City Children With Asthma
Pediatrics,
July 1, 2009;
124(1):
218 - 225.
[Abstract][Full Text][PDF]
G S Lovasi, J W Quinn, K M Neckerman, M S Perzanowski, and A Rundle Children living in areas with more street trees have lower prevalence of asthma
J Epidemiol Community Health,
July 1, 2008;
62(7):
647 - 649.
[Abstract][Full Text][PDF]
K. B. Weiss Eliminating Asthma Disparities: A National Workshop To Set a Working Agenda
Chest,
November 1, 2007;
132(5_suppl):
753S - 756S.
[Abstract][Full Text][PDF]
R. J. Wright and S.V. Subramanian Advancing a Multilevel Framework for Epidemiologic Research on Asthma Disparities
Chest,
November 1, 2007;
132(5_suppl):
757S - 769S.
[Abstract][Full Text][PDF]
J. M. Mangan, A. R. Wittich, and L. B. Gerald The Potential for Reducing Asthma Disparities Through Improved Family and Social Function and Modified Health Behaviors
Chest,
November 1, 2007;
132(5_suppl):
789S - 801S.
[Abstract][Full Text][PDF]
G. B. Diette and C. Rand The Contributing Role of Health-Care Communication to Health Disparities for Minority Patients With Asthma
Chest,
November 1, 2007;
132(5_suppl):
802S - 809S.
[Abstract][Full Text][PDF]
K. B. Weiss Eliminating Asthma Disparities: Introduction to the Chicago Story
Chest,
November 1, 2007;
132(5_suppl):
856S - 857S.
[Abstract][Full Text][PDF]
S. Timmermans Why modest geographic effects for asthma? Pharmaceutical treatment as neutralizing mechanism
Health (London) ,
October 1, 2007;
11(4):
431 - 454.
[Abstract][PDF]
K. M. Conn, J. S. Halterman, K. Lynch, and M. D. Cabana The Impact of Parents' Medication Beliefs on Asthma Management
Pediatrics,
September 1, 2007;
120(3):
e521 - e526.
[Abstract][Full Text][PDF]
J. S. Halterman, S. Fisher, K. M. Conn, M. Fagnano, K. Lynch, A. Marky, and P. G. Szilagyi Improved preventive care for asthma: a randomized trial of clinician prompting in pediatric offices.
Arch Pediatr Adolesc Med,
October 1, 2006;
160(10):
1018 - 1025.
[Abstract][Full Text][PDF]
R. T. Cohen, J. C. Celedon, V. J. Hinckson, C. D. Ramsey, D. B. Wakefield, S. T. Weiss, and M. M. Cloutier Health-care use among puerto rican and african-american children with asthma.
Chest,
August 1, 2006;
130(2):
463 - 471.
[Abstract][Full Text][PDF]
L. J. Bauman, E. J. Silver, and R. E.K. Stein Cumulative Social Disadvantage and Child Health
Pediatrics,
April 1, 2006;
117(4):
1321 - 1328.
[Abstract][Full Text][PDF]
E. A. Halm, P. Mora, and H. Leventhal No Symptoms, No Asthma: The Acute Episodic Disease Belief Is Associated With Poor Self-Management Among Inner-City Adults With Persistent Asthma
Chest,
March 1, 2006;
129(3):
573 - 580.
[Abstract][Full Text][PDF]
P. G. Szilagyi, A. W. Dick, J. D. Klein, L. P. Shone, J. Zwanziger, A. Bajorska, and H. L. Yoos Improved Asthma Care After Enrollment in the State Children's Health Insurance Program in New York
Pediatrics,
February 1, 2006;
117(2):
486 - 496.
[Abstract][Full Text][PDF]
J. S. Halterman, K. M. Conn, E. Forbes-Jones, M. Fagnano, A. D. Hightower, and P. G. Szilagyi Behavior Problems Among Inner-City Children With Asthma: Findings From a Community-Based Sample
Pediatrics,
February 1, 2006;
117(2):
e192 - e199.
[Abstract][Full Text][PDF]
G. M. Hunninghake, S. T. Weiss, and J. C. Celedon Asthma in Hispanics
Am. J. Respir. Crit. Care Med.,
January 15, 2006;
173(2):
143 - 163.
[Abstract][Full Text][PDF]
P. D. Blanc, I. H. Yen, H. Chen, P. P. Katz, G. Earnest, J. R. Balmes, L. Trupin, N. Friedling, E. H. Yelin, and M. D. Eisner Area-level socio-economic status and health status among adults with asthma and rhinitis
Eur. Respir. J.,
January 1, 2006;
27(1):
85 - 94.
[Abstract][Full Text][PDF]
P. S. Higgins, D. Wakefield, and M. M. Cloutier Risk Factors for Asthma and Asthma Severity in Nonurban Children in Connecticut
Chest,
December 1, 2005;
128(6):
3846 - 3853.
[Abstract][Full Text][PDF]
E. A. Halm, J. P. Wisnivesky, and H. Leventhal Quality and Access to Care Among a Cohort of Inner-city Adults With Asthma: Who Gets Guideline Concordant Care?
Chest,
October 1, 2005;
128(4):
1943 - 1950.
[Abstract][Full Text][PDF]
V. Tatis, D. Remache, and E. DiMango Results of a Culturally Directed Asthma Intervention Program in an Inner-city Latino Community
Chest,
September 1, 2005;
128(3):
1163 - 1167.
[Abstract][Full Text][PDF]
S. W. Nicholas, B. Jean-Louis, B. Ortiz, M. Northridge, K. Shoemaker, R. Vaughan, M. Rome, G. Canada, V. Hutchinson, and For The Harlem Children's Zone Asthma Initiative Addressing the Childhood Asthma Crisis in Harlem: The Harlem Children's Zone Asthma Initiative
Am J Public Health,
February 1, 2005;
95(2):
245 - 249.
[Abstract][Full Text][PDF]
L. Schweitzer and A. Valenzuela Jr. Environmental Injustice and Transportation: The Claims and the Evidence
Journal of Planning Literature,
May 1, 2004;
18(4):
383 - 398.
[Abstract][PDF]
J. S. Halterman, P. G. Szilagyi, H. L. Yoos, K. M. Conn, J. M. Kaczorowski, R. J. Holzhauer, S. C. Lauver, T. L. Neely, P. M. Callahan, and K. M. McConnochie Benefits of a School-Based Asthma Treatment Program in the Absence of Secondhand Smoke Exposure: Results of a Randomized Clinical Trial
Arch Pediatr Adolesc Med,
May 1, 2004;
158(5):
460 - 467.
[Abstract][Full Text][PDF]
R. J. Wright, H. Mitchell, C. M. Visness, S. Cohen, J. Stout, R. Evans, and D. R. Gold Community Violence and Asthma Morbidity: The Inner-City Asthma Study
Am J Public Health,
April 1, 2004;
94(4):
625 - 632.
[Abstract][Full Text][PDF]
R. Lenhardt, A. Malone, E. N. Grant, and K. B. Weiss Trends in Emergency Department Asthma Care in Metropolitan Chicago: Results From the Chicago Asthma Surveillance Initiative
Chest,
November 1, 2003;
124(5):
1774 - 1780.
[Abstract][Full Text][PDF]
G. Cesaroni, S. Farchi, M. Davoli, F. Forastiere, and C.A. Perucci Individual and area-based indicators of socioeconomic status and childhood asthma
Eur. Respir. J.,
October 1, 2003;
22(4):
619 - 624.
[Abstract][Full Text][PDF]
E. D. Boudreaux, S. D. Emond, S. Clark, and C. A. Camargo Jr Acute Asthma Among Adults Presenting to the Emergency Department: The Role of Race/Ethnicity and Socioeconomic Status
Chest,
September 1, 2003;
124(3):
803 - 812.
[Abstract][Full Text][PDF]
M. Stafford and M. Marmot Neighbourhood deprivation and health: does it affect us all equally?
Int. J. Epidemiol.,
June 1, 2003;
32(3):
357 - 366.
[Abstract][Full Text][PDF]
E. D. Boudreaux, S. D. Emond, S. Clark, and C. A. Camargo Jr Race/Ethnicity and Asthma Among Children Presenting to the Emergency Department: Differences in Disease Severity and Management
Pediatrics,
May 1, 2003;
111(5):
e615 - 621.
[Abstract][Full Text][PDF]
G. R. Bloomberg, K. M. Trinkaus, E. B. Fisher Jr., J. R. Musick, and R. C. Strunk Hospital Readmissions for Childhood Asthma: A 10-Year Metropolitan Study
Am. J. Respir. Crit. Care Med.,
April 15, 2003;
167(8):
1068 - 1076.
[Abstract][Full Text][PDF]
P. W. Newacheck, R. E. K. Stein, L. Bauman, Y.-Y. Hung, and for the Research Consortium on Children With Chron Disparities in the Prevalence of Disability Between Black and White Children
Arch Pediatr Adolesc Med,
March 1, 2003;
157(3):
244 - 248.
[Abstract][Full Text][PDF]
M. B. Bracken, K. Belanger, W. O. Cookson, E. Triche, D. C. Christiani, and B. P. Leaderer Genetic and Perinatal Risk Factors for Asthma Onset and Severity: A Review and Theoretical Analysis
Epidemiol. Rev.,
December 1, 2002;
24(2):
176 - 189.
[Full Text][PDF]
M. M. Cloutier, D. B. Wakefield, C. B. Hall, and H. L. Bailit Childhood Asthma in an Urban Community: Prevalence, Care System, and Treatment
Chest,
November 1, 2002;
122(5):
1571 - 1579.
[Abstract][Full Text][PDF]
A. L. Fuhlbrigge, R. J. Adams, T. W. Guilbert, E. Grant, P. Lozano, S. L. Janson, F. Martinez, K. B. Weiss, and S. T. Weiss The Burden of Asthma in the United States: Level and Distribution Are Dependent on Interpretation of the National Asthma Education and Prevention Program Guidelines
Am. J. Respir. Crit. Care Med.,
October 15, 2002;
166(8):
1044 - 1049.
[Abstract][Full Text][PDF]
L. J. Akinbami and K. C. Schoendorf Trends in Childhood Asthma: Prevalence, Health Care Utilization, and Mortality
Pediatrics,
August 1, 2002;
110(2):
315 - 322.
[Abstract][Full Text][PDF]
T. A. Lieu, P. Lozano, J. A. Finkelstein, F. W. Chi, N. G. Jensvold, A. M. Capra, C. P. Quesenberry, J. V. Selby, and H. J. Farber Racial/Ethnic Variation in Asthma Status and Management Practices Among Children in Managed Medicaid
Pediatrics,
May 1, 2002;
109(5):
857 - 865.
[Abstract][Full Text][PDF]
M. A. Rodriguez, M. A. Winkleby, D. Ahn, J. Sundquist, and H. C. Kraemer Identification of Population Subgroups of Children and Adolescents With High Asthma Prevalence: Findings From the Third National Health and Nutrition Examination Survey
Arch Pediatr Adolesc Med,
March 1, 2002;
156(3):
269 - 275.
[Abstract][Full Text][PDF]
J. S. Halterman, H. L. Yoos, J. M. Kaczorowski, K. McConnochie, R. J. Holzhauer, K. M. Conn, S. Lauver, and P. G. Szilagyi Providers Underestimate Symptom Severity Among Urban Children With Asthma
Arch Pediatr Adolesc Med,
February 1, 2002;
156(2):
141 - 146.
[Abstract][Full Text][PDF]
S. R. Wilson, E. G. Yamada, R. Sudhakar, L. Roberto, D. Mannino, C. Mejia, and N. Huss A Controlled Trial of an Environmental Tobacco Smoke Reduction Intervention in Low-Income Children With Asthma
Chest,
November 1, 2001;
120(5):
1709 - 1722.
[Abstract][Full Text][PDF]
J. G. Ford, I. H. Meyer, P. Sternfels, S. E. Findley, D. E. McLean, J. K. Fagan, and L. Richardson Patterns and Predictors of Asthma-Related Emergency Department Use in Harlem
Chest,
October 1, 2001;
120(4):
1129 - 1135.
[Abstract][Full Text][PDF]
J. P. Almeida and J. S. Lwebuga-Mukasa Geographic Variations in Asthma Mortality in Erie and Niagara Counties, Western New York, 1991-1996
Am J Public Health,
September 1, 2001;
91(9):
1394 - 1395.
[Full Text][PDF]
D. M. STEINBACHER and M. GLICK The dental patient with asthma: An update and oral health considerations
J Am Dent Assoc,
September 1, 2001;
132(9):
1229 - 1239.
[Abstract][Full Text][PDF]
J. A. Krishnan, G. B. Diette, E. A. Skinner, B. D. Clark, D. Steinwachs, and A. W. Wu Race and Sex Differences in Consistency of Care With National Asthma Guidelines in Managed Care Organizations
Arch Intern Med,
July 9, 2001;
161(13):
1660 - 1668.
[Abstract][Full Text][PDF]
H. A. Werner Status Asthmaticus in Children : A Review
Chest,
June 1, 2001;
119(6):
1913 - 1929.
[Abstract][Full Text][PDF]
R. Shegog, L. K. Bartholomew, G. S. Parcel, M. M. Sockrider, L. Mâsse, and S. L. Abramson Impact of a Computer-assisted Education Program on Factors Related to Asthma Self-management Behavior
J. Am. Med. Inform. Assoc.,
January 1, 2001;
8(1):
49 - 61.
[Abstract][Full Text]
S. A Reijneveld, R. A Verheij, and D. H de Bakker The impact of area deprivation on differences in health: does the choice of the geographical classification matter?
J Epidemiol Community Health,
April 1, 2000;
54(4):
306 - 313.
[Abstract][Full Text]
H Moudgil, T Marshall, and D Honeybourne Asthma education and quality of life in the community: a randomised controlled study to evaluate the impact on white European and Indian subcontinent ethnic groups from socioeconomically deprived areas in Birmingham, UK
Thorax,
March 1, 2000;
55(3):
177 - 183.
[Abstract][Full Text]
R. J Rona Asthma and poverty
Thorax,
March 1, 2000;
55(3):
239 - 244.
[Full Text]
D. M. HOMA, D. M. MANNINO, and M. LARA Asthma Mortality in U.S. Hispanics of Mexican, Puerto Rican, and Cuban Heritage, 1990-1995
Am. J. Respir. Crit. Care Med.,
February 1, 2000;
161(2):
504 - 509.
[Abstract][Full Text]
J. S. Halterman, C. A. Aligne, P. Auinger, J. T. McBride, and P. G. Szilagyi Inadequate Therapy for Asthma Among Children in the United States
Pediatrics,
January 1, 2000;
105(1):
272 - 276.
[Abstract][Full Text]
W. W. Addington and K. B. Weiss Chicago's Response to the Public Health Challenge of Urban Asthma
Chest,
October 1, 1999;
116
(2009):
132S - 134S.
[Full Text][PDF]
S. D. Thomas and S. Whitman Asthma Hospitalizations and Mortality in Chicago: An Epidemiologic Overview
Chest,
October 1, 1999;
116
(2009):
135S - 141S.
[Abstract][Full Text][PDF]
K. B. Weiss and E. N. Grant The Chicago Asthma Surveillance Initiative: A Community-Based Approach to Understanding Asthma Care
Chest,
October 1, 1999;
116
(2009):
141S - 145S.
[Abstract][Full Text][PDF]
C. CASSINO, K. ITO, I. BADER, C. CIOTOLI, G. THURSTON, and J. REIBMAN Cigarette Smoking and Ozone-Associated Emergency Department Use for Asthma by Adults in New York City
Am. J. Respir. Crit. Care Med.,
June 1, 1999;
159(6):
1773 - 1779.
[Abstract][Full Text]
E Duran-Tauleria and R J Rona Geographical and socioeconomic variation in the prevalence of asthma symptoms in English and Scottish children
Thorax,
June 1, 1999;
54(6):
476 - 481.
[Abstract][Full Text]
K. M. McConnochie, M. J. Russo, J. T. McBride, P. G. Szilagyi, A.-M. Brooks, and K. J. Roghmann Socioeconomic Variation in Asthma Hospitalization: Excess Utilization or Greater Need?
Pediatrics,
June 1, 1999;
103(6):
75e - 75.
[Abstract][Full Text]
K. M. McConnochie, M. J. Russo, J. T. McBride, P. G. Szilagyi, A. M. Brooks, and K. J. Roghmann How Commonly Are Children Hospitalized for Asthma Eligible for Care in Alternative Settings?
Arch Pediatr Adolesc Med,
January 1, 1999;
153(1):
49 - 55.
[Abstract][Full Text][PDF]
N. K. LEIDY, K. S. CHAN, and C. COUGHLIN Is the Asthma Quality of Life Questionnaire a Useful Measure for Low-income Asthmatics?
Am. J. Respir. Crit. Care Med.,
October 1, 1998;
158(4):
1082 - 1090.
[Abstract][Full Text][PDF]
K. M. McConnochie, K. J. Roghmann, and G. S. Liptak Diagnostic Clusters in Infants as Child Health Outcomes: Variation among Socioeconomic Areas in One Community
Eval Health Prof,
September 1, 1998;
21(3):
332 - 361.
[Abstract][PDF]
T. D. WEIR, N. MALLEK, A. J. SANDFORD, T. R. BAI, N. AWADH, J. M. FITZGERALD, D. COCKCROFT, A. JAMES, S. B. LIGGETT, and P. D. PARE beta 2-Adrenergic Receptor Haplotypes in Mild, Moderate and Fatal/Near Fatal Asthma
Am. J. Respir. Crit. Care Med.,
September 1, 1998;
158(3):
787 - 791.
[Abstract][Full Text][PDF]
E. M. ZORATTI, S. HAVSTAD, J. RODRIGUEZ, Y. ROBENS-PARADISE, J. E. LAFATA, and B. MCCARTHY Health Service Use by African Americans and Caucasians with Asthma in a Managed Care Setting
Am. J. Respir. Crit. Care Med.,
August 1, 1998;
158(2):
371 - 377.
[Abstract][Full Text][PDF]
H Moudgil and D Honeybourne Differences in asthma management between white European and Indian subcontinent ethnic groups living in socioeconomically deprived areas in the Birmingham (UK) conurbation
Thorax,
June 1, 1998;
53(6):
490 - 494.
[Abstract][Full Text]
B D W Harrison Psychosocial aspects of asthma in adults
Thorax,
June 1, 1998;
53(6):
519 - 525.
[Full Text]
D. Calmes, B. D. Leake, and D. M. Carlisle Adverse Asthma Outcomes Among Children Hospitalized With Asthma in California
Pediatrics,
May 1, 1998;
101(5):
845 - 850.
[Abstract][Full Text][PDF]
T. A. LIEU, C. P. QUESENBERRY, M. E. SOREL, G. R. MENDOZA, and A. B. LEONG Computer-based Models to Identify High-risk Children with Asthma
Am. J. Respir. Crit. Care Med.,
April 1, 1998;
157(4):
1173 - 1180.
[Abstract][Full Text][PDF]
E. F. Crain, C. Kercsmar, K. B. Weiss, H. Mitchell, and H. Lynn Reported Difficulties in Access to Quality Care for Children With Asthma in the Inner City
Arch Pediatr Adolesc Med,
April 1, 1998;
152(4):
333 - 339.
[Abstract][Full Text][PDF]
J Kolbe, W Fergusson, and J Garrett Rapid onset asthma: a severe but uncommon manifestation
Thorax,
April 1, 1998;
53(4):
241 - 247.
[Abstract][Full Text]
B. N. Samuels, A. H. Novack, D. P. Martin, and F. A. Connell Comparison of Length of Stay for Asthma by Hospital Type
Pediatrics,
April 1, 1998;
101
(4):
e13 - e13.
[Abstract][Full Text][PDF]
D. C. Goodman, T. A. Stukel, and C.-h. Chang Trends in Pediatric Asthma Hospitalization Rates: Regional and Socioeconomic Differences
Pediatrics,
February 1, 1998;
101(2):
208 - 213.
[Abstract][Full Text][PDF]
W. M. Tierney, M. D. Murray, D. L. Gaskins, and X.-H. Zhou Using Computer-based Medical Records to Predict Mortality Risk for Inner-city Patients with Reactive Airways Disease
J. Am. Med. Inform. Assoc.,
July 1, 1997;
4(4):
313 - 321.
[Abstract][Full Text][PDF]
K. M. McConnochie, K. J. Roghmann, H. J. Kitzman, G. S. Liptak, and J. T. McBride Ensuring High-Quality Alternatives While Ending Pediatric Inpatient Care as We Know It
Arch Pediatr Adolesc Med,
April 1, 1997;
151(4):
341 - 349.
[Abstract][PDF]
D. Evans, R. Mellins, K. Lobach, C. Ramos-Bonoan, M. Pinkett-Heller, S. Wiesemann, I. Klein, C. Donahue, D. Burke, M. Levison, et al. Improving Care for Minority Children With Asthma: Professional Education in Public Health Clinics
Pediatrics,
February 1, 1997;
99(2):
157 - 164.
[Abstract][Full Text][PDF]
E. Duran-Tauleria, R. J Rona, S. Chinn, and P. Burney Influence of ethnic group on asthma treatment in children in 1990-1: national cross sectional study
BMJ,
July 20, 1996;
313(7050):
148 - 152.
[Abstract][Full Text]
J. M. Perrin, P. Greenspan, S. R. Bloom, D. Finkelstein, S. Yazdgerdi, J. M. Leventhal, L. Rodewald, P. Szilagyi, and C. J. Homer Primary Care Involvement Among Hospitalized Children
Arch Pediatr Adolesc Med,
May 1, 1996;
150(5):
479 - 486.
[Abstract][PDF]
P. Lozano, F. A. Connell, and T. D. Koepsell Use of Health Services by African-American Children With Asthma on Medicaid
JAMA,
August 9, 1995;
274(6):
469 - 473.
[Abstract][PDF]
K. J. Chou, S. J. Cunningham, and E. F. Grain Metered-Dose Inhalers With Spacers vs Nebulizers for Pediatric Asthma
Arch Pediatr Adolesc Med,
February 1, 1995;
149(2):
201 - 205.
[Abstract][PDF]
D. M. Lang and M. Polansky Patterns of Asthma Mortality in Philadelphia from 1969 to 1991
N. Engl. J. Med.,
December 8, 1994;
331(23):
1542 - 1546.
[Abstract][Full Text]
J. J. Hisnanick, D. A. Coddington, and P. J. Gergen Trends in Asthma-Related Admissions Among American Indian and Alaskan Native Children From 1979 to 1989: Universal Health Care in the Face of Poverty
Arch Pediatr Adolesc Med,
April 1, 1994;
148(4):
357 - 363.
[Abstract][PDF]
M. Weitzman, S. L. Gortmaker, A. M. Sobol, and J. M. Perrin Recent Trends in the Prevalence and Severity of Childhood Asthma
JAMA,
November 18, 1992;
268(19):
2673 - 2677.
[Abstract][PDF]