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Original Research: Asthma |

Epidemiology of Asthma Hospitalizations Among American Indian and Alaska Native People and the General United States PopulationAsthma Hospitalizations in the United States

Jason M. Mehal, MPH; Robert C. Holman, MS; Claudia A. Steiner, MD, MPH; Michael L. Bartholomew, MD; Rosalyn J. Singleton, MD
Author and Funding Information

From the Division of High-Consequence Pathogens and Pathology (Messrs Mehal and Holman), National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (DHHS), Atlanta, GA; the Healthcare Cost and Utilization Project (Dr Steiner), Center for Delivery, Organizations, and Markets, Agency for Healthcare Research and Quality, DHHS, Rockville, MD; the Indian Health Service (Dr Bartholomew), DHHS, Rockville, MD; the Alaska Native Tribal Health Consortium (Dr Singleton), Anchorage, AK; and the Arctic Investigations Program (Dr Singleton), Division of Preparedness and Emerging Infections, NCEZID, CDC, DHHS, Anchorage, AK.

CORRESPONDENCE TO: Jason M. Mehal, MPH, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS A-30, Atlanta, GA 30333; e-mail: jmehal@cdc.gov


FUNDING/SUPPORT: The authors have reported to CHEST that no funding was received for this study.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;146(3):624-632. doi:10.1378/chest.14-0183
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BACKGROUND:  Asthma, a common chronic disease among adults and children in the United States, results in nearly one-half million hospitalizations annually. There has been no evaluation of asthma hospitalizations for American Indian and Alaska Native (AI/AN) people since a previous study using data for 1988-2002. In this study, we describe the epidemiology and trends for asthma hospitalizations among AI/AN people and the general US population for 2003-2011.

METHODS:  Hospital discharge records with a first-listed diagnosis of asthma for 2003-2011 were examined for AI/AN people, using Indian Health Service (IHS) data, and for the general US population, using the Nationwide Inpatient Sample. Average annual crude and age-adjusted hospitalization rates were calculated.

RESULTS:  The average annual asthma hospitalization rates for AI/AN people and the general US population decreased from 2003-2005 to 2009-2011 (32% and 11% [SE, 3%], respectively). The average annual age-adjusted rate for 2009-2011 was lower for AI/AN people (7.6 per 10,000 population) compared with the general US population (13.2 per 10,000; 95% CI, 12.8-13.6). Age-specific AI/AN rates were highest among infants and children 1 to 4 years of age. IHS regional rates declined in all regions except Alaska.

CONCLUSIONS:  Asthma hospitalization rates are decreasing for AI/AN people and the general US population despite increasing prevalence rates. AI/AN people experienced a substantially lower age-adjusted asthma hospitalization rate compared with the general US population. Although the rates for AI/AN infants and children 1 to 4 years of age have declined substantially, they remain higher compared with other age groups. Improved disease management and awareness should help to further decrease asthma hospitalizations, particularly among young children.

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