142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Alarmingly High Prevalence of Asthma in Puerto Rican Island Children

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Sunday, November 16, 2014

Marielena Lara, MD, MPH , RAND Health, Santa Monica, CA
Gilberto Ramos-Valencia, DrPH , Department of Biostatistics and Epidemiology, University of Puerto Rico-Medical Sciences Campus, Graduate School of Public Health, San Juan, PR
Claudia Diaz, PhD , Economics Department, University of New Mexico, Albuquerque, NM
Beatriz Morales Reyes
Jesús Gonzalez-Gavillán, PhD , School of Public Health, UPR School of Public Health, San Juan, PR
Background: The asthma epidemic continues to puzzle scientists and health practitioners worldwide. Previous reports have suggested how asthma can disproportionately affect people living in the island of Puerto Rico.

Objectives: As part of a needs assessment conducted in two low income neighborhoods in San Juan, Puerto Rico, we sought to: i) describe the prevalence of a lifetime asthma diagnosis and asthma-related symptoms among children living in these communities, and ii) explore individual, household, and community-level sociodemographic  and environmental risk factors associated with these outcomes

Methods: A door-to-door household survey conducted by trained interviewers used previously validated measures including household micro-environmental factors (i.e., mold, rodents, cockroaches), and individual behavioral risk factors (i.e., smoking habits) and sociodemographics.  GIS measures included exposure to some community level factors, such as crime and access to care, approximated by using distance vectors to the centroid of buildings were participants lived.  Data analyses included exploration of bivariate relationships between the primary outcomes (asthma prevalence and related symptoms) and the covariates of interests, followed by calculation of crude and adjusted odds ratios.

Results: Crude lifetime prevalence of childhood asthma was 44% across both communities.  Forty-six percent of all children were reported to have wheeze at some point in their lives regardless of having an asthma diagnosis.  Both individual-level factors (being male, younger age, and having a parent or grandparent with active asthma) and household-level factors (presence of mold, reported problems with roaches) were associated with higher odds of an asthma diagnosis in multivariate analyses.  

Conclusion:  Children in the Island of Puerto Rican have among the highest asthma prevalence rates in the world.  Risk factors at the individual, household, and community level are associated with asthma in this population.

Learning Areas:

Social and behavioral sciences

Learning Objectives:
Describe prevalence among low income children in Puerto Rico Identify individual and family level determinants of asthma prevalence

Keyword(s): Asthma, Public Health Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked for the past 7 years in Latino health research. My research includes individual and family effects on short and long term health outcomes in the context of income insecurity and poverty. My scientific interests include policy impacts on dyadic health outcomes (caregiver and individual), as well as health information for preventive care.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.