title: Ethnicity and risk of hospitalization for asthma and chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  To identify ethnic differences for risk of hospitalization for asthma and chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  We undertook a cohort study with 126,019 participants: 55% whites, 27% blacks, 11% Asians, and 4% Hispanics. To estimate asthma and COPD risk, we used Cox proportional hazards models adjusted for age, sex, body mass index, education, smoking, and alcohol intake. End points were hospitalizations for asthma or COPD.
  
  
  RESULTS
  Compared with whites, relative risks (RR) with 95% confidence intervals (95% CI) for asthma among other groups were: blacks, 1.7 (1.4-2.0); Hispanics, 0.9 (0.6-1.4); and Asians, 1.6 (1.2-2.1). Among Asians, increased risk was concentrated in Filipino men and women and South Asian men. For COPD, whites were at highest risk; RR of blacks was 0.9 (0.7-1.0); Hispanics, 0.6 (0.3- 0.9); and Asians, 0.4 (0.3-0.6). COPD risk among Asians was lowest in Chinese with RR of 0.3 (0.1-0.5).
  
  
  CONCLUSIONS
  Ethnic disparities in risk of asthma and COPD as well as between both diseases exist, especially for Asian Americans, who have high asthma risk and low COPD risk. While residual confounding for smoking or other environmental factors could be partially responsible, genetic factors in Asians may be involved in decreased COPD risk.
authors.affiliation: Department of Medicine, Kaiser Permanente Medical Care Program, Oakland, California 94611, USA. Nicole.H.Tran@kp.org
authors.forename: H Nicole
authors.initials: HN
authors.lastname: Tran
authors.forename: Stanton
authors.initials: S
authors.lastname: Siu
authors.forename: Carlos
authors.initials: C
authors.lastname: Iribarren
authors.forename: Natalia
authors.initials: N
authors.lastname: Udaltsova
authors.forename: Arthur L
authors.initials: AL
authors.lastname: Klatsky
mesh_terms: D000367:Age Factors; D000428:Alcohol Drinking; D044466:Asian People / Q000706:statistics & numerical data; D001249:Asthma / Q000453:epidemiology / Q000208:ethnology* / Q000628:therapy*; D044383:Black People / Q000706:statistics & numerical data; D015992:Body Mass Index; D002140:California / Q000453:epidemiology; D015331:Cohort Studies; D004522:Educational Status; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000208:ethnology* / Q000628:therapy*; D012307:Risk Factors; D012737:Sex Factors; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American