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Pulmonary Disease and Age at Immigration among Hispanics. Results from the Hispanic Community Health Study/Study of Latinos.

TitlePulmonary Disease and Age at Immigration among Hispanics. Results from the Hispanic Community Health Study/Study of Latinos.
Publication TypePublication
Year2016
AuthorsR Barr G, Avilés-Santa L, Davis SM, Aldrich TK, Gonzalez F, Henderson AG, Kaplan RC, Lavange L, Liu K, Loredo JS, Mendes ES, Ni A, Ries A, Salathe M, Smith LJ
JournalAm J Respir Crit Care Med
Volume193
Issue4
Pagination386-95
Date Published2016 Feb 15
ISSN1535-4970
KeywordsAdult, Age Factors, asthma, Central America, Cohort Studies, Emigrants and Immigrants, Emigration and Immigration, Female, Health Surveys, Hispanic or Latino, Humans, Male, Mexico, Middle Aged, Odds Ratio, Prevalence, Pulmonary Disease, Chronic Obstructive, Risk Factors, South America, spirometry, Surveys and Questionnaires, United States, West Indies
Abstract

RATIONALE: Asthma has been reported to be more prevalent among Hispanics of Puerto Rican heritage than among other Hispanics and among Hispanics born in the United States or who immigrated as children than among those who came as adults; however, direct comparisons across Hispanic groups are lacking.OBJECTIVES: To test whether asthma is more prevalent among Hispanics of Puerto Rican heritage than among other Hispanic groups, whether asthma is associated with age of immigration, and whether chronic obstructive pulmonary disease varies by heritage in a large, population-based cohort of Hispanics in the United States.METHODS: The Hispanic Community Health Study/Study of Latinos researchers recruited a population-based probability sample of 16,415 Hispanics/Latinos, 18-74 years of age, in New York City, Chicago, Miami, and San Diego. Participants self-reported Puerto Rican, Cuban, Dominican, Mexican, Central American, or South American heritage; birthplace; and, if relevant, age at immigration. A respiratory questionnaire and standardized spirometry were performed with post-bronchodilator measures for those with airflow limitation.MEASUREMENTS AND MAIN RESULTS: The prevalence of physician-diagnosed asthma among Puerto Ricans (36.5%; 95% confidence interval, 33.6-39.5%) was higher than among other Hispanics (odds ratio, 3.9; 95% confidence interval, 3.3-4.6). Hispanics who were born in the mainland United States or had immigrated as children had a higher asthma prevalence than those who had immigrated as adults (19.6, 19.4, and 14.1%, respectively; P < 0.001). Current asthma, bronchodilator responsiveness, and wheeze followed similar patterns. Chronic obstructive pulmonary disease prevalence was higher among Puerto Ricans (14.1%) and Cubans (9.8%) than among other Hispanics (<6.0%), but it did not vary across Hispanic heritages after adjustment for smoking and prior asthma (P = 0.22), by country of birth, or by age at immigration.CONCLUSIONS: Asthma was more prevalent among Puerto Ricans, other Hispanics born in the United States, and those who had immigrated as children than among other Hispanics. In contrast, the higher prevalence of chronic obstructive pulmonary disease among Puerto Ricans and Cubans was largely reflective of differential smoking patterns and asthma.

DOI10.1164/rccm.201506-1211OC
Alternate JournalAm J Respir Crit Care Med
PubMed ID26451874
PubMed Central IDPMC4803083
Grant ListN01-HC-95162 / HC / NHLBI NIH HHS / United States
N01HC95160 / HL / NHLBI NIH HHS / United States
N01HC95163 / HL / NHLBI NIH HHS / United States
UL1 TR001079 / TR / NCATS NIH HHS / United States
N01-HC-95163 / HC / NHLBI NIH HHS / United States
N01-HC-95168 / HC / NHLBI NIH HHS / United States
N01HC95169 / HL / NHLBI NIH HHS / United States
R01 HL077612 / HL / NHLBI NIH HHS / United States
N01HC65236 / HL / NHLBI NIH HHS / United States
N01-HC-95159 / HC / NHLBI NIH HHS / United States
N01HC65235 / HL / NHLBI NIH HHS / United States
RC1 HL100543 / HL / NHLBI NIH HHS / United States
N01-HC-95165 / HC / NHLBI NIH HHS / United States
N01HC95164 / HL / NHLBI NIH HHS / United States
N01-HC65237 / HC / NHLBI NIH HHS / United States
N01HC95162 / HL / NHLBI NIH HHS / United States
N01HC65234 / HL / NHLBI NIH HHS / United States
R01 HL093081 / HL / NHLBI NIH HHS / United States
N01HC95168 / HL / NHLBI NIH HHS / United States
R01-HL077612 / HL / NHLBI NIH HHS / United States
N01HC65233 / HL / NHLBI NIH HHS / United States
K23 HL083091 / HL / NHLBI NIH HHS / United States
N01-HC-95169 / HC / NHLBI NIH HHS / United States
N01HC65237 / HL / NHLBI NIH HHS / United States
N01-HC65233 / HC / NHLBI NIH HHS / United States
N01-HC-95164 / HC / NHLBI NIH HHS / United States
N01HC95165 / HL / NHLBI NIH HHS / United States
N01HC95159 / HL / NHLBI NIH HHS / United States
UL1-TR-000040 / TR / NCATS NIH HHS / United States
N01HC95161 / HL / NHLBI NIH HHS / United States
N01-HC-95160 / HC / NHLBI NIH HHS / United States
N01-HC65234 / HC / NHLBI NIH HHS / United States
N01-HC65236 / HC / NHLBI NIH HHS / United States
N01HC95167 / HL / NHLBI NIH HHS / United States
N01-HC-95161 / HC / NHLBI NIH HHS / United States
UL1 TR000040 / TR / NCATS NIH HHS / United States
UL1-TR-001079 / TR / NCATS NIH HHS / United States
N01HC95166 / HL / NHLBI NIH HHS / United States
N01-HC-95166 / HC / NHLBI NIH HHS / United States
R01-HL083091 / HL / NHLBI NIH HHS / United States
N01-HC65235 / HC / NHLBI NIH HHS / United States
RC1-HL100543 / HL / NHLBI NIH HHS / United States
N01-HC-95167 / HC / NHLBI NIH HHS / United States
P30 ES009089 / ES / NIEHS NIH HHS / United States
MS#: 
0010
Manuscript Lead/Corresponding Author Affiliation: 
HCHS/SOL Baseline Visit - Pulmonary Reading Center - Columbia University
ECI: 
Manuscript Status: 
Published