Does the relationship between asthma and obesity differ by neighborhood?
BACKGROUND
Prior studies suggest that obesity may cause asthma. Obesity and asthma are prevalent in low-income urban neighborhoods, but the impact of obesity on asthma in such neighborhoods has not been examined.


METHODS
The New York City Department of Health and Mental Hygiene surveyed 6119 adults age 18-54 years in 2002. Obesity was defined as body mass index > or = 30 kg/m(2) and current asthma as physician diagnosed asthma plus recent symptoms. We calculated prevalence (risk) differences (RD) and population attributable risk percents (PAR%).


RESULTS
Obese individuals had a 2.0% (95% CI: 0.5%, 3.6%; p=0.01) higher risk of current asthma than normal weight individuals overall. Obesity was more common in low-income neighborhoods compared with middle-to-upper-income neighborhoods (23% vs. 14%, p<0.001), as was current asthma (6% vs. 4%, respectively, p=0.02). The risk of current asthma associated with obesity was similar in low-income (RD: 1.3%, 95% CI: -1.5%, 4.0%; p=0.36) and middle-to-upper-income neighborhoods (RD: 2.0%, 95% CI: 0.1%, 3.9%; p=0.04). The PAR% for asthma due to obesity was not greater in low-income (7.3%) than in middle-to-upper-income neighborhoods (7.7%).


CONCLUSIONS
It is unlikely that the excess asthma prevalence in urban low-income neighborhoods is disproportionately attributable to obesity. Instead, alternative causes of excess asthma should be sought.
Tonorezos
Emily S
ES
Division of Pulmonary and Critical Care Medicine, Department of Medicine, New York University, New York, NY, USA.
Karpati
Adam M
AM
Wang
Yuanjia
Y
Barr
R Graham
RG
D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000453:epidemiology / Q000209:etiology*; D004522:Educational Status; D005260:Female; D006306:Health Surveys; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D011204:Poverty Areas; D015995:Prevalence; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014504:Urban Health / Q000706:statistics & numerical data*; D055815:Young Adult