Skip to main content
NCBI home page
American Journal of Public Health logoLink to American Journal of Public Health
. 1992 Jan;82(1):59–65. doi: 10.2105/ajph.82.1.59

Variations in asthma hospitalizations and deaths in New York City.

W Carr 1, L Zeitel 1, K Weiss 1
PMCID: PMC1694413  PMID: 1536336

Abstract

BACKGROUND. Recent reports have identified New York City as having asthma mortality rates that are substantially higher than expected based on US rates. This study investigates the problems of asthma morbidity and mortality in New York City. METHODS. Data on asthma hospitalizations (1982 to 1986) and deaths (1982 to 1987) among persons aged 0 to 34 years were studied. Descriptive and multivariate techniques were used to examine differences in rates among subgroups and across geographic areas. RESULTS. The average annual hospitalization rate was 39.2 per 10,000; the mortality rate was 1.2 per 100,000. Hospitalization and death rates among Blacks and Hispanics were 3 to 5.5 times those of Whites. Large geographic variations in hospitalizations and mortality occurred. Asthma hospitalization and mortality rates were highly correlated (r = .67), with the highest rates concentrated in the city's poorest neighborhoods. Household income, percentage of population Black, and percentage of population Hispanic were significant predictors of area hospitalization rates (adjusted R2 = .75). CONCLUSION. These findings provide a basis for focusing investigations of the causes of variations in asthma outcomes and targeting interventions to reduce the disproportionate morbidity and mortality borne by poor and minority populations.

Full text

PDF
59

Images in this article

61FIGURE 1
on p.61

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barger L. W., Vollmer W. M., Felt R. W., Buist A. S. Further investigation into the recent increase in asthma death rates: a review of 41 asthma deaths in Oregon in 1982. Ann Allergy. 1988 Jan;60(1):31–39. [PubMed] [Google Scholar]
  2. Dockery D. W., Speizer F. E., Stram D. O., Ware J. H., Spengler J. D., Ferris B. G., Jr Effects of inhalable particles on respiratory health of children. Am Rev Respir Dis. 1989 Mar;139(3):587–594. doi: 10.1164/ajrccm/139.3.587. [DOI] [PubMed] [Google Scholar]
  3. Gergen P. J., Weiss K. B. Changing patterns of asthma hospitalization among children: 1979 to 1987. JAMA. 1990 Oct 3;264(13):1688–1692. [PubMed] [Google Scholar]
  4. German P. S., Skinner E. A., Shapiro S., Salkever D. S. Preventive and episodic health care of inner-city children. J Community Health. 1976 Winter;2(2):92–106. doi: 10.1007/BF01319087. [DOI] [PubMed] [Google Scholar]
  5. Goldstein I. F., Reed C. E., Swanson M. C., Jacobson J. S. Aeroallergens in New York inner-city apartments of asthmatics. Experientia Suppl. 1987;51:133–138. doi: 10.1007/978-3-0348-7491-5_23. [DOI] [PubMed] [Google Scholar]
  6. Kerner J. F., Andrews H., Zauber A., Struening E. Geographically-based cancer control: methods for targeting and evaluating the impact of screening interventions on defined populations. J Clin Epidemiol. 1988;41(6):543–553. doi: 10.1016/0895-4356(88)90058-3. [DOI] [PubMed] [Google Scholar]
  7. Perrin J. M., Homer C. J., Berwick D. M., Woolf A. D., Freeman J. L., Wennberg J. E. Variations in rates of hospitalization of children in three urban communities. N Engl J Med. 1989 May 4;320(18):1183–1187. doi: 10.1056/NEJM198905043201805. [DOI] [PubMed] [Google Scholar]
  8. Rutstein D. D., Berenberg W., Chalmers T. C., Child C. G., 3rd, Fishman A. P., Perrin E. B. Measuring the quality of medical care. A clinical method. N Engl J Med. 1976 Mar 11;294(11):582–588. doi: 10.1056/NEJM197603112941104. [DOI] [PubMed] [Google Scholar]
  9. Sears M. R., Rea H. H., de Boer G., Beaglehole R., Gillies A. J., Holst P. E., O'Donnell T. V., Rothwell R. P. Accuracy of certification of deaths due to asthma. A national study. Am J Epidemiol. 1986 Dec;124(6):1004–1011. doi: 10.1093/oxfordjournals.aje.a114470. [DOI] [PubMed] [Google Scholar]
  10. Shepherd R. W., Holt T. L., Cleghorn G., Ward L. C., Isles A., Francis P. Short-term nutritional supplementation during management of pulmonary exacerbations in cystic fibrosis: a controlled study, including effects of protein turnover. Am J Clin Nutr. 1988 Aug;48(2):235–239. doi: 10.1093/ajcn/48.2.235. [DOI] [PubMed] [Google Scholar]
  11. Sly R. M. Effects of treatment on mortality from asthma. Ann Allergy. 1986 Mar;56(3):207–212. [PubMed] [Google Scholar]
  12. Sporik R., Holgate S. T., Platts-Mills T. A., Cogswell J. J. Exposure to house-dust mite allergen (Der p I) and the development of asthma in childhood. A prospective study. N Engl J Med. 1990 Aug 23;323(8):502–507. doi: 10.1056/NEJM199008233230802. [DOI] [PubMed] [Google Scholar]
  13. Weiss K. B., Wagener D. K. Changing patterns of asthma mortality. Identifying target populations at high risk. JAMA. 1990 Oct 3;264(13):1683–1687. [PubMed] [Google Scholar]
  14. Weiss K. B., Wagener D. K. Geographic variations in US asthma mortality: small-area analyses of excess mortality, 1981-1985. Am J Epidemiol. 1990 Jul;132(1 Suppl):S107–S115. doi: 10.1093/oxfordjournals.aje.a115771. [DOI] [PubMed] [Google Scholar]
  15. Wennberg J. E., McPherson K., Caper P. Will payment based on diagnosis-related groups control hospital costs? N Engl J Med. 1984 Aug 2;311(5):295–300. doi: 10.1056/NEJM198408023110505. [DOI] [PubMed] [Google Scholar]
  16. Wissow L. S., Gittelsohn A. M., Szklo M., Starfield B., Mussman M. Poverty, race, and hospitalization for childhood asthma. Am J Public Health. 1988 Jul;78(7):777–782. doi: 10.2105/ajph.78.7.777. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES