title: Epidemiology of asthma hospitalizations among American Indian and Alaska Native people and the general United States population.
abstract: BACKGROUND
  Asthma, a common chronic disease among adults and children in the United States, results in nearly one-half million hospitalizations annually. There has been no evaluation of asthma hospitalizations for American Indian and Alaska Native (AI/AN) people since a previous study using data for 1988-2002. In this study, we describe the epidemiology and trends for asthma hospitalizations among AI/AN people and the general US population for 2003-2011.
  
  
  METHODS
  Hospital discharge records with a first-listed diagnosis of asthma for 2003-2011 were examined for AI/AN people, using Indian Health Service (IHS) data, and for the general US population, using the Nationwide Inpatient Sample. Average annual crude and age-adjusted hospitalization rates were calculated.
  
  
  RESULTS
  The average annual asthma hospitalization rates for AI/AN people and the general US population decreased from 2003-2005 to 2009-2011 (32% and 11% [SE, 3%], respectively). The average annual age-adjusted rate for 2009-2011 was lower for AI/AN people (7.6 per 10,000 population) compared with the general US population (13.2 per 10,000; 95% CI, 12.8-13.6). Age-specific AI/AN rates were highest among infants and children 1 to 4 years of age. IHS regional rates declined in all regions except Alaska.
  
  
  CONCLUSIONS
  Asthma hospitalization rates are decreasing for AI/AN people and the general US population despite increasing prevalence rates. AI/AN people experienced a substantially lower age-adjusted asthma hospitalization rate compared with the general US population. Although the rates for AI/AN infants and children 1 to 4 years of age have declined substantially, they remain higher compared with other age groups. Improved disease management and awareness should help to further decrease asthma hospitalizations, particularly among young children.
authors.affiliation: Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (DHHS), Atlanta, GA. Electronic address: jmehal@cdc.gov.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Mehal
authors.affiliation: Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (DHHS), Atlanta, GA.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Holman
authors.affiliation: Healthcare Cost and Utilization Project, Center for Delivery, Organizations, and Markets, Agency for Healthcare Research and Quality, DHHS, Rockville, MD.
authors.forename: Claudia A
authors.initials: CA
authors.lastname: Steiner
authors.affiliation: Indian Health Service, DHHS, Rockville, MD.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Bartholomew
authors.affiliation: Alaska Native Tribal Health Consortium, Arctic Investigations Program, Division of Preparedness and Emerging Infections, NCEZID, CDC, DHHS, Anchorage, AK.
authors.forename: Rosalyn J
authors.initials: RJ
authors.lastname: Singleton
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000413:Alaska; D001249:Asthma / Q000453:epidemiology* / Q000208:ethnology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D007198:Indians, North American; D007223:Infant; D004930:Inuit; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D016549:United States Indian Health Service / Q000706:statistics & numerical data / Q000639:trends; D055815:Young Adult