Skip to main content

Master of Public Health

Pediatric Asthma Incidence Rates in the United States from 1980-2017

AUTHORS

Johnson CC , Havstad SL , Ownby DR , Joseph CLM , Sitarik AR , Biagini Myers J , Gebretsadik T , Hartert TV , Khurana Hershey GK , Jackson DJ , Lemanske RF , Martin LJ , Zoratti EM , Visness CM , Ryan PH , Gold DR , Martinez FD , Miller RL , Seroogy CM , Wright AL , Gern JE , , . The Journal of allergy and clinical immunology. 2021 5 5; ().

ABSTRACT

BACKGROUND: Few studies have examined longitudinal asthma incidence rates from a public health surveillance perspective.

OBJECTIVE: Calculate descriptive asthma incidence rates in children over time considering demographics and parental asthma history.

METHODS: Data from nine US birth cohorts were pooled into one population covering 1980-2017. The outcome was earliest parental report of a doctor diagnosis of asthma. Incidence rates per 1,000 person-years were calculated.

RESULTS: The 6,283 children were 55% European-American (EA), 25.5% African-American (AA), 9.5% Mexican-Hispanic American (MA) and 8.5% Caribbean-Hispanic American (CA). Average follow-up was 10.4 years (SD=8.5 years, median=8.4) totaling 65,291 person-years, with 1789 asthma diagnoses yielding a crude incidence rate of 27.5 per 1000 person-years (95% CI 26.3-28.8). Age-specific rates were highest among children 0-4 years, notably from 1995-1999, with a decline in EA/MAs in 2000-2004 followed by a decline in AA/CAs in 2010-2014. Parental asthma history was associated with statistically significantly increased rates. Incidence rates were similar and higher in AA and CA compared to lower but similar rates in EA and MA. Differential rates by sex from birth through adolescence principally resulted from a decline in male but relatively stable female rates.

CONCLUSIONS: US childhood asthma incidence rates varied dramatically by age, sex, parental asthma history, race and calendar year. Higher rates in the 0-4 year-olds, particularly in AA/CA males with a parental history, and changes in rates over time and by demographic factors, suggests that asthma is driven by complex interactions between genetic susceptibility and variation in time-dependent environmental and social factors.

Tags: