Racial disparities in asthma-related health outcomes in severe or difficult-to-treat asthma.
BACKGROUND
The underlying reasons for racial disparities in asthma morbidity are not well understood. Multivariate epidemiologic studies evaluating the presence and extent of racial differences in a large cohort of adults with severe or difficult-to-treat asthma are lacking.


OBJECTIVE
To analyze an extensive array of clinical and patient-reported outcomes, using multivariate analysis with a sequential approach, to explain racial differences in asthma-related outcomes in one of the largest cohorts of difficult-to-treat asthmatic patients.


METHODS
Black and white patients (> or = 18-years-old at baseline) were included (n = 2,128). Differences between the 2 racial groups were assessed using several outcome measures at month 12. Assessments were adjusted for confounding variables using a sequence of statistical models.


RESULTS
Most patients were white (88.6%). Blacks were slightly younger, less educated, and more likely to live in urban areas than whites. Blacks were more likely to have severe asthma and to be treated with 3 or more long-term controllers. Poorer quality of life, more asthma control problems, and higher risk of emergency department visits were observed in blacks compared with whites; differences were not explained by adjustment for broad sets of confounding variables. Differences in asthma-related health outcomes remained statistically significant after adjusting for asthma severity.


CONCLUSIONS
Asthma is a serious health problem in blacks and is not explained by differences in demographics, severity, or other health conditions.
Haselkorn
Tmirah
T
Genentech Inc., 1 DNA Way, South San Francisco, CA 94080, USA. haselkorn.tmirah@gene.com
Lee
June H
JH
Mink
David R
DR
Weiss
Scott T
ST
D000328:Adult; D001249:Asthma / Q000208:ethnology* / Q000503:physiopathology / Q000628:therapy*; D044383:Black People / Q000706:statistics & numerical data; D015331:Cohort Studies; D004638:Emergency Treatment / Q000706:statistics & numerical data; D005541:Forced Expiratory Volume / Q000502:physiology; D054624:Health Status Disparities; D006801:Humans; D007407:Interviews as Topic; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010349:Patient Compliance / Q000706:statistics & numerical data; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American