BACKGROUND: The underlying reasons for racial disparities in asthma morbidity are not well understood. Multivariate epidemiologic studies evaluating the presence and extent of racial differences in a large cohort of adults with severe or difficult-to-treat asthma are lacking. OBJECTIVE: To analyze an extensive array of clinical and patient-reported outcomes, using multivariate analysis with a sequential approach, to explain racial differences in asthma-related outcomes in one of the largest cohorts of difficult-to-treat asthmatic patients. METHODS: Black and white patients (> or = 18-years-old at baseline) were included (n = 2,128). Differences between the 2 racial groups were assessed using several outcome measures at month 12. Assessments were adjusted for confounding variables using a sequence of statistical models. RESULTS: Most patients were white (88.6%). Blacks were slightly younger, less educated, and more likely to live in urban areas than whites. Blacks were more likely to have severe asthma and to be treated with 3 or more long-term controllers. Poorer quality of life, more asthma control problems, and higher risk of emergency department visits were observed in blacks compared with whites; differences were not explained by adjustment for broad sets of confounding variables. Differences in asthma-related health outcomes remained statistically significant after adjusting for asthma severity. CONCLUSIONS: Asthma is a serious health problem in blacks and is not explained by differences in demographics, severity, or other health conditions.
BACKGROUND: The underlying reasons for racial disparities in asthma morbidity are not well understood. Multivariate epidemiologic studies evaluating the presence and extent of racial differences in a large cohort of adults with severe or difficult-to-treat asthma are lacking. OBJECTIVE: To analyze an extensive array of clinical and patient-reported outcomes, using multivariate analysis with a sequential approach, to explain racial differences in asthma-related outcomes in one of the largest cohorts of difficult-to-treat asthmatic patients. METHODS: Black and white patients (> or = 18-years-old at baseline) were included (n = 2,128). Differences between the 2 racial groups were assessed using several outcome measures at month 12. Assessments were adjusted for confounding variables using a sequence of statistical models. RESULTS: Most patients were white (88.6%). Blacks were slightly younger, less educated, and more likely to live in urban areas than whites. Blacks were more likely to have severe asthma and to be treated with 3 or more long-term controllers. Poorer quality of life, more asthma control problems, and higher risk of emergency department visits were observed in blacks compared with whites; differences were not explained by adjustment for broad sets of confounding variables. Differences in asthma-related health outcomes remained statistically significant after adjusting for asthma severity. CONCLUSIONS: Asthma is a serious health problem in blacks and is not explained by differences in demographics, severity, or other health conditions.
Authors: Steven Stern; Elizabeth Merwin; Emily Hauenstein; Ivora Hinton; Virginia Rovnyak; Melvin Wilson; Ishan Williams; Irma Mahone Journal: Health Serv Outcomes Res Methodol Date: 2010-08-06
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Authors: Christy Gamble; Evelyn Talbott; Ada Youk; Fernando Holguin; Bruce Pitt; Lori Silveira; Eugene Bleecker; William Busse; William Calhoun; Mario Castro; Kian Fan Chung; Serpil Erzurum; Elliot Israel; Sally Wenzel Journal: J Allergy Clin Immunol Date: 2010-11-04 Impact factor: 10.793
Authors: Kathryn Blake; James D Cury; Jobayer Hossain; Kelan Tantisira; Jianwei Wang; Edward Mougey; John Lima Journal: Pulm Pharmacol Ther Date: 2013-02-04 Impact factor: 3.410
Authors: G Wegienka; S Havstad; C L M Joseph; E Zoratti; D Ownby; K Woodcroft; C C Johnson Journal: Clin Exp Allergy Date: 2012-06 Impact factor: 5.018