The Journal of Allergy and Clinical Immunology
Volume 124, Issue 2 , Pages 238-244.e5 , August 2009

Conundrums in childhood asthma severity, control, and health care use: Puerto Rico versus Rhode Island

  • Cynthia A. Esteban, MSN, MPH

      Affiliations

    • Department of Pediatrics, Division of Allergy and Immunology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI
    • Corresponding Author InformationReprint requests: Cynthia Esteban, MSN, MPH, Asthma and Allergy Center, 1 Hoppin St, Suite 304A, Providence, RI 02903.
    • ,
  • Robert B. Klein, MD

      Affiliations

    • Department of Pediatrics, Division of Allergy and Immunology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI
    • ,
  • Elizabeth L. McQuaid, PhD

      Affiliations

    • Department of Psychiatry, Division of Child Psychiatry, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI
    • ,
  • Gregory K. Fritz, MD

      Affiliations

    • Department of Psychiatry, Division of Child Psychiatry, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI
    • ,
  • Ronald Seifer, PhD

      Affiliations

    • Department of Psychiatry, Division of Child Psychiatry, Warren Alpert Medical School of Brown University, E. P. Bradley Hospital, Providence, RI
    • ,
  • Sheryl J. Kopel, MSc

      Affiliations

    • Department of Psychiatry, Division of Child Psychiatry, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI
    • ,
  • Jose Rodriguez Santana, MD

      Affiliations

    • University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
    • ,
  • Angel Colon, MD

      Affiliations

    • University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
    • ,
  • Maria Alvarez, MD

      Affiliations

    • University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
    • ,
  • Daphne Koinis-Mitchell, PhD

      Affiliations

    • Department of Psychiatry, Division of Child Psychiatry, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI
    • ,
  • Alexander N. Ortega, PhD

      Affiliations

    • Department of Health Services, School of Public Health, University of California, Los Angeles, Calif
    • ,
  • Brenda Martinez-Nieves, PhD

      Affiliations

    • Department of Behavioral Medicine, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
    • ,
  • Glorisa Canino, PhD

      Affiliations

    • Department of Behavioral Medicine, University of Puerto Rico School of Medicine, San Juan, Puerto Rico

Received 16 May 2008 ,Revised 14 April 2009 ,Accepted 12 May 2009.

  • Image Result

    Asthma severity distribution by study group. Puerto Ricans (PR) had significantly milder asthma compared with RI Puerto Ricans (RI-PR; P < .001), RI Dominicans (RI-DR; P < .001), and RI whites (P < .0

    Asthma severity distribution by study group. Puerto Ricans (PR) had significantly milder asthma compared with RI Puerto Ricans (RI-PR; P < .001), RI Dominicans (RI-DR; P < .001), and RI whites (P < .001). There were no significant differences among the 3 groups in RI.

  • Image Result
    ED visits and hospitalizations in the past 12 months by study group. Puerto Ricans (PR) had significantly more ED visits (P < .001) compared with the 3 groups in RI. Island Puerto Ricans had more hosp

    ED visits and hospitalizations in the past 12 months by study group. Puerto Ricans (PR) had significantly more ED visits (P < .001) compared with the 3 groups in RI. Island Puerto Ricans had more hospitalizations compared with RI whites and RI Dominicans (RI-DR; P < .001). RI Puerto Ricans (RI-PR) were not significantly different from island Puerto Ricans in hospitalizations.

 Supported by U01-H1072438 (G. C. and G. F, P.I.s) from the National Heart, Lung, and Blood Institute. G. C.'s time is also supported by 5P60 MD002261-02 from the National Center of Minority Health and Health Disparities.

 Disclosure of potential conflict of interest: E. L. McQuaid has received research support from the National Institute of Nursing Research, National Institute of Children's Health and Development, and the National Heart, Lung, and Blood Institute. G. K. Fritz has received research support from the National Heart, Lung, and Blood Institute and National Institute of Mental Health, and is an editor at Wiley-Blackwell Publishing. R. Seifer has received research support from the National Institutes of Health, the Administration for Children and Families, the National Science Foundation, and the Substance Abuse and Mental Health Services Administration. D. Koinis-Mitchell has received research support from the National Institute of Allergy and Infectious Diseases and the National Heart, Lung, and Blood Institute. A. N. Ortega has received research support from the National Institute of Mental Health. The rest of the authors have declared that they have no conflict of interest.

PII: S0091-6749(09)00806-9

doi: 10.1016/j.jaci.2009.05.014

The Journal of Allergy and Clinical Immunology
Volume 124, Issue 2 , Pages 238-244.e5 , August 2009

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