title: Asthma prevalence and severity in Arab American communities in the Detroit area, Michigan.
abstract: Immigrant populations provide a unique intersection of cultural and environmental risk factors implicated in asthma etiology. This study focuses on asthma prevalence and severity in 600 Arab American households in metro Detroit, the largest immigrant reception zone for Arab Americans in North America. The survey method introduced a number of novel features: (a) a ranking scheme for the key environmental risk factors for asthma was used to derive an aggregated environmental risk index (ERI) for each household, and (b) an aggregate measure of asthma severity based on symptom frequency and intensity. Environmental risk factors and surrogates for socioeconomic status (SES) were found to be stronger predictors of asthma prevalence than asthma severity, while demographic variables such as English fluency and birth in the United States were better predictors of asthma severity than asthma prevalence. These results suggest that SES variables may be more reflective of environmental exposures in communities involved in this study, while English fluency and birth in the United States may be linked to health care access and utilization behavior that can influence the asthma management. We also found a significant relationship between asthma prevalence and degree of acculturation. Asthma prevalence was highest among moderately acculturated immigrants compared with new immigrants and those who were well acculturated, suggesting that among Arab Americans in the Detroit area, risk factors associated with new immigrant status are replaced by "western" risk factors as the population becomes more acculturated.
authors.affiliation: Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Johnson
authors.forename: Jerome
authors.initials: J
authors.lastname: Nriagu
authors.forename: Adnan
authors.initials: A
authors.lastname: Hammad
authors.forename: Kathryn
authors.initials: K
authors.lastname: Savoie
authors.forename: Hikmet
authors.initials: H
authors.lastname: Jamil
mesh_terms: D000069:Acculturation; D000328:Adult; D000368:Aged; D018912:Arabs / Q000706:statistics & numerical data*; D001249:Asthma / Q000453:epidemiology* / Q000208:ethnology; D001294:Attitude to Health / Q000208:ethnology*; D003466:Cultural Characteristics; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D008877:Middle East / Q000208:ethnology; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012923:Social Class; D014504:Urban Health / Q000706:statistics & numerical data*