Abstract
IntroductionIn the United States, children in Puerto Rico and non-Hispanic black children in the mainland US have a higher burden of asthma than non-Hispanic white children in the mainland US. We examined indoor environmental control (IEC) practices that reduce asthma triggers, by race/ethnicity among children in the mainland US and Puerto Rico. MethodsWe used 2013 and 2014 data from the Behavioral Risk Factor Surveillance System Asthma Call-back Survey Child Questionnaire from 14 states and Puerto Rico to measure the association between race/ethnicity and IEC practices, adjusting for sociodemographic covariates, among children identified as ever receiving an asthma diagnosis. Racial/ethnic groups were compared in 14 US states using aggregated data. Separate analyses compared IEC practices for children diagnosed with asthma in Puerto Rico with children of all races/ethnicities diagnosed with asthma in 14 states.ResultsAmong households in 14 US states that had a child with asthma, non-Hispanic black children were more likely than non-Hispanic white children to use an air purifier (36.8% vs 25.2%; adjusted odds ratio [aOR] = 2.0; 95% confidence interval [CI], 1.3–3.2) and avoid pets in the bedroom (87.9% vs 58.3%; aOR = 4.5; 95% CI, 2.3–8.8). Children in Puerto Rico were more likely than children in 14 states to use dust mite–impermeable pillow covers (53.7% vs 36.4%; aOR = 3.6; 95% CI, 1.8–7.1) and mattress encasements (60.3% vs 30.3%; aOR = 2.4; 95% CI, 1.2–4.8).ConclusionIEC practices such as using air purifiers, pillow covers, mattress encasements, and avoiding pets in the bedroom vary by race/ethnicity among children with asthma. These findings show that vulnerable populations are using IEC practices, but asthma prevention and control measures should continue to be assessed.
Highlights
Introduction In the UnitedStates, children in Puerto Rico and non-Hispanic black children in the mainland US have a higher burden of asthma than non-Hispanic white children in the mainland US
Among households in 14 US states that had a child with asthma, non-Hispanic black children were more likely than non-Hispanic white children to use an air purifier (36.8% vs 25.2%; adjusted odds ratio [aOR] = 2.0; 95% confidence interval [CI], 1.3–3.2) and avoid pets in the bedroom (87.9% vs 58.3%; aOR = 4.5; 95% CI, 2.3–8.8)
Children in Puerto Rico were more likely than children in 14 states to use dust mite–impermeable pillow covers (53.7% vs 36.4%; aOR = 3.6; 95% CI, 1.8–7.1) and mattress encasements (60.3% vs 30.3%; aOR = 2.4; 95% CI, 1.2–4.8)
Summary
Children in Puerto Rico and non-Hispanic black children in the mainland US have a higher burden of asthma than non-Hispanic white children in the mainland US. Puerto Rican children are an additional vulnerable population who experience the highest prevalence of asthma (11%) compared with non-Hispanic black (7.7%) and non-Hispanic white children (5.3%) in the US mainland. In Puerto Rico, 32% of children have received a diagnosis of asthma, compared with 12.6% of children in the US mainland [3]. The lifetime odds of having received an asthma diagnosis among Puerto Rico island resident children born to Puerto Rico island residents is 2.5 times higher than United States mainland-born non-Hispanic white children with United States mainland-born parents [4]
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