Adjusted asthma prevalence varied widely among API subgroups, being 40-50% higher in Filipino adults and South Asian men, but 30% lower in Chinese women compared to White counterparts.
Cross-Sectional (n=1,183,576)
Asthma prevalence varies significantly among disaggregated Asian and Pacific Islander subgroups, highlighting the need to understand specific ethnic patterns for optimizing clinical care.
Abstract Rationale Asthma is a chronic lung condition characterized by small airway inflammation and reversible obstruction, affecting 25 million Americans. Asthma burden varies by race/ethnicity, but few studies have examined ethnic patterns among disaggregated Asian and Pacific Islander (API) populations. Among Asian adults, limited research suggests that Filipino Americans are at highest risk for asthma, associated with higher body mass index (BMI) and acculturation. In this study, we examine asthma prevalence in a large, disaggregated population of older API adults, using data from an integrated healthcare system. Methods A retrospective study was conducted using cross-sectional data from 1,183,576 adult members of a large U.S. healthcare system who were aged 50-89y during 2017-2019 and had measured BMI. Asthma was ascertained based on ≥ 2 outpatient visit diagnoses (ICD-10 J45) during the 3-year time period. Age-standardized prevalence was calculated using 2018 U.S. Census data. Modified Poisson regression with robust variance was performed to examine the association between race/ethnicity and asthma, adjusting for age, BMI category, smoking, and neighborhood deprivation index quartile based on U.S. Census data. Results Among 1,183,576 adults (mean age 64±10y, 54% female, 55% non-Hispanic White, 7% Black, 12% Hispanic, 18% API), 143,563 (12%) had diagnosed asthma. Among men, the age-standardized prevalence of asthma was 9-10% for White, Black, Hispanic, and API men, with larger variation among API subgroups: 11-12% for Filipino, South Asian, and Native Hawaiian/Pacific Islander (NHPI), 9% for Japanese and Vietnamese, and 7% for Chinese men. Among women, the age-standardized prevalence of asthma was higher for Black (18%) and Hispanic (16%) compared to White women (14%) and lower for API women in aggregate (12%), though NHPI (19%) and Filipina women (17%) had much higher asthma prevalence and Chinese women had much lower prevalence (8%). Accounting for age, BMI, and other factors, the adjusted prevalence of asthma was 10% higher for Black adults, 20-30% higher for Vietnamese men and NHPI adults, and 40-50% for Filipino adults and South Asian men compared to sex-specific White counterparts, whereas prevalence was 10% lower for Chinese men and Japanese women, and 30% lower for Chinese women. Conclusions Asthma prevalence varies by race/ethnicity and API subgroup, with sex-specific differences. Higher prevalence was observed among Filipino and NHPI adults and South Asian men, though lower among Chinese adults and Japanese women compared to their sex-specific White counterparts. Understanding asthma risk in disaggregated API subgroups is essential for optimizing clinical care and treatment in these understudied populations. This abstract is funded by: National Institutes of Health
Lu et al. (Fri,) conducted a cross-sectional in Asthma (n=1,183,576). Asian and Pacific Islander (API) race/ethnicity vs. White race/ethnicity was evaluated on Asthma prevalence. Adjusted asthma prevalence varied widely among API subgroups, being 40-50% higher in Filipino adults and South Asian men, but 30% lower in Chinese women compared to White counterparts.