Differences in asthma prevalence between samples of American Indian and Alaska Native children.
OBJECTIVE
To better understand the prevalence of asthma among American Indian and Alaska Native (AI/AN) children and to explore the contribution of locale to asthma symptoms and diagnostic assignment, the authors surveyed AI/AN middle school students, comparing responses from metropolitan Tacoma, Washington (metro WA) and a non-metropolitan area of Alaska (non-metro AK).


METHODS
Students in grades 6-9 completed an asthma screening survey. The authors compared self-reported rates of asthma symptoms, asthma diagnoses, and health care utilization for 147 children ages 11-16 self-reporting as AI/AN in metro WA and 365 in non-metro AK.


RESULTS
The prevalences of self-reported asthma symptoms were similar for the metro WA and non-metro AK populations, but a significantly higher percentage of metro WA than of non-metro AK respondents reported having received a physician diagnosis of asthma (OR 2.33; 95% CI 1.23, 4.39). The percentages of respondents who reported having visited a medical provider for asthma-like symptoms in the previous year did not differ.


CONCLUSIONS
The difference in rates of asthma diagnosis despite similar rates of asthma symptoms and respiratory-related medical visits may reflect differences in respiratory disease patterns, diagnostic labeling practices, or environmental factors. Future attempts to describe asthma prevalence should consider the potential contribution of non-biologic factors such as diagnostic practices.
Stout
J W
JW
Department of Pediatrics, School of Medicine, University of Washington, Seattle, USA. jstout@u.washington.edu
White
L C
LC
Redding
G J
GJ
Morray
B H
BH
Martinez
P E
PE
Gergen
P J
PJ
D000293:Adolescent; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D002669:Child Welfare; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D004930:Inuit / Q000706:statistics & numerical data*; D008297:Male; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data*; D013334:Students / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014504:Urban Health / Q000706:statistics & numerical data*