Racial disparities in asthma among Whites, Blacks, and Black-White biracials

Objectives: Black-White biracials have the highest lifetime prevalence of asthma, exceeding both single-race Whites and Blacks, according to a study that uses data from the National Health Interview Survey (NHIS). This study examines the individual and neighborhood characteristics contributing to disparities in asthma risk among Whites, Blacks, and Black-White biracials and cross-validates previous findings using the National Longitudinal Study of Adolescent Health (Add Health).

Methods: This analysis is based on waves I and III of Add Health. Self-reported race is used to classify respondents. Weighted and variance-corrected generalized logistic regression models are used with history of asthma diagnosis as the dependent variable. Models adjust for parental educational status, access to healthcare, health insurance status, family history of asthma, and neighborhood urbanicity.

Results: Black-White biracials have the highest lifetime prevalence of asthma at 31.1%, far exceeding single-race Whites and Blacks at 18.9% and 20.5% for both groups, respectively. In comparison to Whites, non-urban Black-Whites have risks of asthma that are over three times that of Whites (OR=3.95) and urban Black-Whites are at lower risk than Whites (OR=0.81). The reverse pattern occurs for Blacks (urban OR=1.39 and non-urban OR=0.81).

Conclusion: Results from this study suggests that the burden of asthma among the Black-White biracial population is substantial. Non-urban Black-Whites are at the highest risk of asthma even after controlling for socioeconomic factors, family history of asthma, and healthcare indicators. Further research is needed to understand the underlying social causes for the high prevalence of asthma among Black-White biracials.