title: Ethnic variations in UK asthma frequency, morbidity, and health-service use: a systematic review and meta-analysis.
abstract: BACKGROUND
  The frequency of asthma varies between countries, and may also vary between ethnic groups in more geographically confined areas. We sought evidence of such ethnic variations in the UK for asthma frequency, morbidity, and health-services use, and to understand possible reasons for any differences.
  
  
  METHODS
  We searched MEDLINE, EMBASE, CINAHL, PSYCHInfo, PREMEDLINE, HEALTHSTAR, Cambridge Register of Conference Abstracts, the Dissertation and Thesis Database, and the National Registry of Research. Additionally, we searched the bibliographies of reports identified and websites of health authorities, and contacted experts in this discipline. Our main outcomes were comparisons of asthma rate, morbidity, and health-services use. We did meta-analyses using random-effects models.
  
  
  RESULTS
  13 studies contained relevant data. All prevalence studies were of children and showed that south Asian children had a lower frequency of symptoms suggestive of asthma compared with black and white children (pooled rate of history of wheeze in the previous 12 months: south Asians 9.6% [95%CI 8.0-11.2%], black people 16.2% [12.8-19.6%], white people 14.6% [11.5-17.8%]). The pooled frequency of clinician-diagnosed asthma in children followed a similar pattern (south Asians 7.6% [3.7-11.4%], black people 15.0% [3.5-26.5%], white people 10.6% [4.6-16.7%]. However, relative to white people, the risk of admission for asthma in children and adults was higher for south Asians (odds ratio 2.9 [2.4-3.4]) and black people (2.1 [1.8-2.5]).
  
  
  CONCLUSIONS
  The differences in admission are not explained by differences in asthma frequency between groups; they could relate to ethnic variations in asthma severity, differences in health-seeking behaviour, or difficulties in accessing high-quality primary care services.
authors.affiliation: Department of Primary Care & Social Medicine, Imperial College London, London, UK.
authors.forename: Gopalakrishnan
authors.initials: G
authors.lastname: Netuveli
authors.forename: Brian
authors.initials: B
authors.lastname: Hurwitz
authors.forename: Mark
authors.initials: M
authors.lastname: Levy
authors.forename: Monica
authors.initials: M
authors.lastname: Fletcher
authors.forename: Greta
authors.initials: G
authors.lastname: Barnes
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Durham
authors.forename: Aziz
authors.initials: A
authors.lastname: Sheikh
mesh_terms: D001210:Asia, Southeastern / Q000208:ethnology; D001249:Asthma / Q000208:ethnology* / Q000628:therapy; D044383:Black People / Q000706:statistics & numerical data; D006296:Health Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006113:United Kingdom / Q000453:epidemiology