美国哮喘发病率种族差异的时间变化趋势－一项根据行为危险因素监控系统的研究（1999-2011）
2014/12/22
摘要
目的：研究美国哮喘发病率的种族差异是否随着时间增大。
方法：我们根据行为危险因素监控系统分析1999－2011年3 868 956例美国成年哮喘患者的相关数据。采用随机截距模型（患者根据州划分），经过协变量的调整后，分析哮喘患者寿命及发病率的种族差异和时间变化趋势。此外，我们还根据种族差异对主要住宅区的哮喘发病率异质性进行分析。
结果：非西班牙裔黑人群体哮喘患者的寿命及发病率较其它种族更高，并且差异随着时间而增大（b = 0.0078； 95% 可信区间[CI] = 0.0043, 0.0106）。西班牙裔群体哮喘发病率的优势比（ORs）较低（OR = 0.74； 95% CI = 0.73, 0.76）。与墨西哥人或其它种族人群占主体的州相比，波多黎各人占主体的州的西班牙裔美国人更容易患哮喘（OR = 1.55； 95% CI = 1.24, 1.93）。
结论：近年来，哮喘发病率的种族差异逐渐增大，其中，非西班牙裔黑人群体以及与来自波多黎各的西班牙裔群体的哮喘发病率较高。哮喘患者的治疗措施应该根据种族、地理差异而调整。
（杨冬 审校）
Am J Public Health. 2014 Oct 16:e1-e7. [Epub ahead of print]
Time Trends in Racial and Ethnic Disparities in Asthma Prevalence in the United States From the Behavioral Risk Factor Surveillance System (BRFSS) Study (1999-2011).
Bhan N1, Kawachi I, Glymour MM, Subramanian SV.
ABSTRACT
OBJECTIVES：We examined whether racial/ethnic disparities in the United States increased over time.
METHODS：We analyzed data from 3 868 956 adults across the United States from the Behavioral Risk Factor Surveillance System from 1999 to 2011. We used random intercepts models (individuals nested in states) to examine racial/ethnic disparities and time trends in asthma lifetime and its current prevalence, adjusted for covariates. We also investigated the heterogeneity in asthma prevalence by ethnicity of the major zone of residence.
RESULTS：Lifetime and current asthma prevalence were higher among non-Hispanic Black populations, with time trends highlighting increasing differences over time (b = 0.0078; 95% confidence interval [CI] = 0.0043, 0.0106). Lower odds ratios (ORs) of asthma were noted for Hispanic populations (OR = 0.74; 95% CI = 0.73, 0.76). Hispanics in states with more Puerto Rican residents reported greater risks of asthma (OR = 1.55; 95% CI = 1.24, 1.93) compared with Hispanics in states with larger numbers of Mexican or other ethnicities.
CONCLUSIONS：Disparities in asthma prevalence by racial/ethnic groups increased in the last decade, with non-Hispanic Blacks and Puerto Rican Hispanics at greater risk. Interventions targeting asthma treatments need to recognize racial, ethnic, and geographic disparities. (Am J Public Health. Published online ahead of print October 16, 2014: e1-e7. doi:10.2105/AJPH.2014.302172).
Am J Public Health. 2014 Oct 16:e1-e7. [Epub ahead of print]
