title: Area of residence, birthplace, and asthma in Puerto Rican children.
abstract: BACKGROUND
  Puerto Ricans have the highest prevalence of asthma among all ethnic groups in the United States. There have been no studies that directly compare the burden of asthma between Puerto Ricans living in Puerto Rico and those living in the mainland United States.
  
  
  OBJECTIVE
  To examine the relation between birthplace, area of residence, and asthma in Puerto Rican children.
  
  
  METHODS
  Multistage population-based probability sample of children in the San Juan and Caguas metropolitan areas in Puerto Rico and in the Bronx, NY. Information was collected in a household survey of 2,491 children and their primary caretakers.
  
  
  RESULTS
  The overall prevalence of asthma among Puerto Rican children in this study was very high (38.6%). Although children from Puerto Rico had higher socioeconomic status and lower rates of premature birth and prenatal smoke exposure, the prevalence of lifetime asthma was higher in Puerto Rican children living in Puerto Rico than in Puerto Rican children living in the South Bronx (41.3% vs 35.3%, p = 0.01). In multivariable analysis, residence in Puerto Rico was associated with increased odds of lifetime asthma (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.03 to 1.57) and lifetime hospitalization for asthma (OR, 1.47; 95% CI, 1.04-2.07).
  
  
  CONCLUSIONS
  Puerto Rican children in Puerto Rico had a higher risk of asthma than Puerto Rican children in the South Bronx, highlighting the need for further examination of the roles of migration, acculturation, and environmental and psychosocial factors on the development of asthma in this high-risk population.
authors.affiliation: Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA. robyn.cohen@childrens.harvard.edu
authors.forename: Robyn T
authors.initials: RT
authors.lastname: Cohen
authors.forename: Glorisa J
authors.initials: GJ
authors.lastname: Canino
authors.forename: Hector R
authors.initials: HR
authors.lastname: Bird
authors.forename: Sa
authors.initials: S
authors.lastname: Shen
authors.forename: Bernard A
authors.initials: BA
authors.lastname: Rosner
authors.forename: Juan C
authors.initials: JC
authors.lastname: Celedón
mesh_terms: D001249:Asthma / Q000453:epidemiology* / Q000208:ethnology* / Q000209:etiology; D002648:Child; D015331:Cohort Studies; D005260:Female; D006630:Hispanic or Latino / Q000208:ethnology*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009519:New York City / Q000453:epidemiology; D016017:Odds Ratio; D015995:Prevalence; D011446:Prospective Studies; D011584:Psychology; D011647:Puerto Rico / Q000453:epidemiology / Q000208:ethnology; D012111:Residence Characteristics; D012307:Risk Factors; D012959:Socioeconomic Factors