title: Asthma prevalence among Alaska Native and nonnative residents younger than 20 years enrolled in Medicaid.
abstract: BACKGROUND
  No study of childhood asthma prevalence in Alaska or among Alaska Natives has been conducted.
  
  
  OBJECTIVE
  To determine asthma prevalence among Alaska Medicaid enrollees younger than 20 years, with an emphasis on Alaska Natives, the state's largest minority and predominant rural citizens.
  
  
  METHODS
  A master database was obtained that included all children enrolled in Medicaid during July 1998 through June 1999. Physician, pharmacy, and hospital claims files for International Classification of Diseases codes 493.0x to 493.9x were linked to this master database. Asthma was defined as any asthma-related care or medication claim.
  
  
  RESULTS
  Asthma prevalence among the study population was 6.9%. Alaska Natives had a lower asthma prevalence than nonnatives (risk ratio [RR], 0.70; 95% confidence interval [CI], 0.66-0.75), but among the subgroup of children residing in the state's major urban center, Alaska Natives had a higher prevalence. Overall, 0.22% of the study population experienced an asthma-related hospitalization, with Alaska Natives having a higher risk of hospitalization than nonnatives (RR, 1.6; 95% CI, 1.2-2.3). Among hospitalized children, Alaska Natives were less likely to have received a long-term control medication (RR, 0.54; 95% CI, 0.33-0.88).
  
  
  CONCLUSIONS
  Compared with nonnatives, Alaska Natives have a lower risk of asthma but only among nonurban residents. The increased risk of hospitalization among Alaska Natives may be related to underuse of long-term control medications.
authors.affiliation: Alaska Division of Public Health, Anchorage, Alaska 99524, USA. bdgessne@health.state.ak.us
authors.forename: Bradford D
authors.initials: BD
authors.lastname: Gessner
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000367:Age Factors; D000413:Alaska / Q000453:epidemiology; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000453:epidemiology* / Q000208:ethnology; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007223:Infant; D007229:Infant Welfare; D007231:Infant, Newborn; D008297:Male; D008484:Medicaid; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D013223:Statistics as Topic; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents