American Journal of Respiratory and Critical Care Medicine
Volume 193, Issue 4, 2016, Pages 386-395

Pulmonary disease and age at immigration among hispanics: Results from the hispanic community health study/study of latinos (Article)

Barr R.G.* , Avilés-Santa L. , Davis S.M. , Aldrich T.K. , Gonzalez F., II , Henderson A.G. , Kaplan R.C. , La Vange L. , Liu K. , Loredo J.S. , Mendes E.S. , Ni A. , Ries A. , Salathe M. , Smith L.J.
  • a Department of Medicine, Columbia University Medical Center, 630 West 168th Street, New York, MD 10032, United States, Department of Epidemiology, Columbia University Medical Center, New York, NY, United States
  • b Division of Cardiovascular Sciences, NHLBI, National Institutes of Health, Bethesda, MD, United States
  • c Department of Biostatistics, University of North Carolina, Chapel Hill, NC, United States
  • d Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
  • e Department of Biostatistics, University of North Carolina, Chapel Hill, NC, United States
  • f Department of Medicine, University of North Carolina, Chapel Hill, NC, United States
  • g Department of Epidemiology, Albert Einstein College of Medicine, Bronx, NY, United States
  • h Department of Biostatistics, University of North Carolina, Chapel Hill, NC, United States, U.S. Food and Drug Administration, Silver Spring, MD, United States
  • i Department of Preventative Medicine, Northwestern University, Chicago, IL, United States
  • j Department of Medicine, University of California, San Diego, San Diego, CA, United States
  • k Department of Medicine, University of Miami, Miami, FL, United States
  • l Department of Biostatistics, University of North Carolina, Chapel Hill, NC, United States
  • m Department of Medicine, University of California, San Diego, San Diego, CA, United States
  • n Department of Medicine, University of Miami, Miami, FL, United States
  • o Department of Medicine, Northwestern University, Chicago, IL, United States

Abstract

Rationale: Asthma has been reported to be more prevalent among Hispanics of Puerto Rican heritage than among other Hispanics and among Hispanics born in the United States or who immigrated as children than among those who came as adults; however, direct comparisons across Hispanic groups are lacking. Objectives: To test whether asthma is more prevalent among Hispanics of Puerto Rican heritage than among other Hispanic groups, whether asthma is associated with age of immigration, and whether chronic obstructive pulmonary disease varies by heritage in a large, population-based cohort of Hispanics in the United States. Methods: The Hispanic Community Health Study/Study of Latinos researchers recruited a population-based probability sample of 16,415 Hispanics/Latinos, 18-74 years of age, in New York City, Chicago, Miami, and San Diego. Participants self-reported Puerto Rican, Cuban, Dominican, Mexican, Central American, or South American heritage; birthplace; and, if relevant, age at immigration. A respiratory questionnaire and standardized spirometry were performed with postbronchodilator measures for those with airflow limitation. Measurements and Main Results: The prevalence of physiciandiagnosed asthma among Puerto Ricans (36.5%; 95% confidence interval, 33.6-39.5%)washigher thanamongotherHispanics (odds ratio, 3.9; 95% confidence interval, 3.3-4.6). Hispanics who were born in the mainland United States or had immigrated as children had a higher asthma prevalence than those who had immigrated as adults (19.6, 19.4, and 14.1%, respectively; P<0.001). Current asthma, bronchodilator responsiveness, and wheeze followed similar patterns. Chronic obstructive pulmonary disease prevalence was higher among Puerto Ricans (14.1%) andCubans (9.8%) thanamongother Hispanics (<6.0%), but it did not vary acrossHispanic heritages after adjustment for smoking and prior asthma (P = 0.22), by country of birth, or by age at immigration. Conclusions: Asthma was more prevalent among Puerto Ricans, other Hispanics born in the United States, and those who had immigrated as children than among other Hispanics. In contrast, the higher prevalence of chronic obstructive pulmonary disease among Puerto Ricans and Cubans was largely reflective of differential smoking patterns and asthma.

Author Keywords

Race/ethnicity Asthma social determinants of health chronic obstructive pulmonary disease

Index Keywords

West Indies health survey human South American forced expiratory volume forced vital capacity Odds Ratio middle aged statistics and numerical data immigration Cohort Studies priority journal Health Surveys Central America Central American ethnology Mexico Dominican (Dominica) Hispanic Americans Cuban spirometry chronic obstructive lung disease Surveys and Questionnaires United States Humans migrant Hispanic smoking male Emigrants and Immigrants asthma female South America Mexican risk factor Risk Factors inheritance questionnaire population research prevalence Pulmonary Disease, Chronic Obstructive Article major clinical study adult gender migration physician age Puerto Rican Age Factors cohort analysis Emigration and Immigration probability sample Caribbean Islands
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84988727899&doi=10.1164%2frccm.201506-1211OC&partnerID=40&md5=740267593d19e214770200ea35a2fd4c
DOI: 10.1164/rccm.201506-1211OC
ISSN: 1073449X
Cited by: 38
Original Language: English