The relation of socioeconomic factors and racial/ethnic differences in US asthma mortality.

OBJECTIVES This study described relations between socioeconomic factors and race/ethnicity as risk factors for asthma mortality. METHODS A cross-sectional study was conducted of US mortality records from 1991 through 1996. RESULTS Higher standardized mortality ratios were seen for Blacks vs Whites (3.34 vs 0.65), low vs high educational level (1.51 vs 0.69), and low vs high income (1.46 vs 0.71). Excess mortality for Blacks vs Whites was present in the highest and lowest quintiles of median county income and educational level. The disparity in asthma mortality rates according to median county income and education remained after control for race/ethnicity. CONCLUSIONS Black race/ethnicity appears to be associated, independently from low income and low education, with an elevated risk for asthma mortality.

[1]  W. Hadden,et al.  The increasing disparity in mortality between socioeconomic groups in the United States, 1960 and 1986. , 1993, The New England journal of medicine.

[2]  D. Dockery,et al.  Race, asthma, and persistent wheeze in Philadelphia schoolchildren. , 1996, American journal of public health.

[3]  P. Orris,et al.  Effect of racial and socioeconomic factors on asthma mortality in Chicago. , 1992, Chest.

[4]  L Zeitel,et al.  Variations in asthma hospitalizations and deaths in New York City. , 1992, American journal of public health.

[5]  D. Dockery,et al.  Predictors of asthma and persistent wheeze in a national sample of children in the United States. Association with social class, perinatal events, and race. , 1990, The American review of respiratory disease.

[6]  N. Polissar,et al.  Explaining reduced cancer survival among the disadvantaged. , 1996, The Milbank quarterly.

[7]  D K Wagener,et al.  Changing patterns of asthma mortality. Identifying target populations at high risk. , 1990, JAMA.

[8]  F M Chevarley,et al.  National trends in the morbidity and mortality of asthma in the US. Prevalence, hospitalization and death from asthma over two decades: 1965-1984. , 1987, Chest.

[9]  Johan P Mackenbach,et al.  Socioeconomic inequalities in morbidity and mortality in western Europe , 1997, The Lancet.

[10]  D R Ownby,et al.  Ethnic differences in the prevalence of asthma in middle class children. , 1997, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[11]  I. Onorato,et al.  Tuberculosis and race/ethnicity in the United States: impact of socioeconomic status. , 1998, American journal of respiratory and critical care medicine.

[12]  Turkeltaub Pc,et al.  Prevalence of upper and lower respiratory conditions in the US population by social and environmental factors: data from the second National Health and Nutrition Examination Survey, 1976 to 1980 (NHANES II). , 1991 .

[13]  K. Smith,et al.  Phantom of the area: poverty-area residence and mortality in the United States. , 1998, American journal of public health.

[14]  R. Sly,et al.  Stabilization of asthma mortality. , 1997, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[15]  D. Mannino,et al.  Surveillance for asthma--United States, 1960-1995. , 1998, MMWR. CDC surveillance summaries : Morbidity and mortality weekly report. CDC surveillance summaries.

[16]  L. Kann,et al.  Characteristics of health education among secondary schools--School Health Education Profiles, 1996. , 1998, MMWR. CDC surveillance summaries : Morbidity and mortality weekly report. CDC surveillance summaries.

[17]  M. Polansky,et al.  Patterns of asthma mortality in Philadelphia from 1969 to 1991. , 1994, The New England journal of medicine.

[18]  P. Gergen.  Social class and asthma--distinguishing between the disease and the diagnosis. , 1996, American journal of public health.

[19]  K. Weiss,et al.  The Impact of Poverty on Asthma , 1994 .

[20]  B Starfield,et al.  Poverty, race, and hospitalization for childhood asthma. , 1988, American journal of public health.

[21]  P. Sorlie,et al.  Mortality Effects of Community Socioeconomic Status , 1997, Epidemiology.

[22]  S. Gortmaker,et al.  Racial, social, and environmental risks for childhood asthma. , 1990, American journal of diseases of children.

[23]  D K Wagener,et al.  Breathing better or wheezing worse? The changing epidemiology of asthma morbidity and mortality. , 1993, Annual review of public health.