Effect of Relocation to the U.S. on Asthma Risk Among Hispanics.
BACKGROUND
Asthma prevalence is reportedly higher among U.S.-born relative to foreign-born Hispanics/Latinos. Little is known about rates of asthma onset before and after relocation to the U.S. in Latinos. Asthma rates were examined by U.S. residence and country/territory of origin.


METHODS
In 2015-2016, age at first onset of asthma symptoms was analyzed, defined retrospectively from a cross-sectional survey in 2008-2011, in relation to birthplace and U.S. residence among 15,573 U.S.-dwelling participants (aged 18-76 years) in the Hispanic Community Health Study/Study of Latinos.


RESULTS
Cumulative incidence of asthma through age 30 years ranged from 7.9% among Mexican background individuals to 29.4% among those of Puerto Rican background. Among those born outside the U.S. mainland, the adjusted hazard for asthma was 1.52-fold higher (95% CI=1.25, 1.85) after relocation versus before relocation to the U.S. mainland, with heterogeneity in this association by Hispanic/Latino background (p-interaction<0.0001). Among foreign-born Dominicans and Mexicans, rates of asthma were greater after relocation versus before relocation (adjusted hazard ratio [AHR] for after versus before relocation, 2.42, 95% CI=1.44, 4.05 among Dominicans; AHR=2.90, 95% CI=2.02, 4.16 among Mexicans). Puerto Ricans had modestly increased asthma onset associated with U.S. mainland residence (AHR=1.52, 95% CI=1.06, 2.17). No similar increase associated with U.S. residence was observed among Central/South American immigrants (AHR=0.94, 95% CI=0.53, 1.67). Asthma rates among Cuban immigrants were lower after relocation (AHR=0.45, 95% CI=0.24, 0.82).


CONCLUSIONS
The effect of relocation to the U.S. on asthma risk among Hispanics is not uniform across Hispanic/Latino groups.
Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York. Electronic address: elina.jerschow@einstein.yu.edu.
Elina
E
Jerschow
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York.
Garrett
G
Strizich
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York.
Xiaonan
X
Xue
Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York.
Golda
G
Hudes
Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York.
Simon
S
Spivack
Department of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois.
Victoria
V
Persky
College of Health and Human Services and the Institute for Behavioral and Community Health, San Diego State University, San Diego, California.
Guadalupe X
GX
Ayala
Department of Pediatrics, University of Miami, Miami, Florida.
Alan
A
Delamater
Department of Psychology, University of Miami, Coral Gables, Florida.
Youngmee
Y
Kim
Department of Psychology, University of Miami, Coral Gables, Florida.
Erin
E
Etzel
Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina.
Jianwen
J
Cai
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York.
Robert C
RC
Kaplan
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001249:Asthma / Q000453:epidemiology / Q000208:ethnology* / Q000209:etiology; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D004641:Emigration and Immigration / Q000706:statistics & numerical data; D004777:Environment; D005260:Female; D006306:Health Surveys; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D055815:Young Adult