Asthma in Black African, Black Caribbean and South Asian adolescents in the MRC DASH study: a cross sectional analysis

Melissa J Whitrow,Seeromanie Harding

doi:10.1186/1471-2431-10-18

Abstract

BackgroundEthnic differences in the prevalence of asthma among children in the UK are under-researched. We aimed to determine the ethnic differences in the prevalence of asthma and atopic asthma in children from the main UK ethnic groups, and whether differences are associated with differential distributions in social and psychosocial risk factors.Methods6,643 pupils aged 11-13 years, 80% ethnic minorities. Outcomes were asthma/wheeze with (atopic) and without hay fever/eczema. Risk factors examined were family history of asthma, length of residence in the UK, socioeconomic disadvantage, tobacco exposure, psychological well-being, and body mass index (BMI).ResultsThere was a pattern of lower prevalence of asthma in Black African boys and girls, and Indian and Bangladeshi girls compared to White UK. The overall prevalence was higher in Mixed Black Caribbean/White boys, with more atopic asthma in Black Caribbean boys and Mixed Black Caribbean/White boys due to more hayfever. Poor psychological well-being and family history of asthma were associated with an increased risk of asthma within each ethnic group. UK residence for ≤ 5 years was protective for Black Caribbeans and Black Africans. Increased BMI was associated with an increased reporting of asthma for Black Africans. Adjustments for all variables did not remove the excess asthma reported by Black Caribbean boys (atopic) or Mixed Black Caribbean/White boys.ConclusionThe protective effect of being born abroad accounted for ethnic differences in some groups, signalling a role for socio-environmental factors in patterning ethnic differences in asthma in adolescence.

Highlights

Ethnic differences in the prevalence of asthma among children in the United Kingdom (UK) are under-researched
Black Africans, Indians and Bangladeshis had a lower prevalence of asthma, and Mixed White/Black Caribbeans had a higher prevalence than White UK children (Additional file 1: Table S1)
Black Caribbean and Black African children were less likely to report a positive family history of asthma than White UK, there was a higher proportion of inadequately described family history of asthma in this group

Summary

Introduction

Ethnic differences in the prevalence of asthma among children in the UK are under-researched. Studies of ethnic minority children living in the United Kingdom (UK) and United States (US) have reported inequalities in the prevalence of asthma, wheeze and atopy [1,2,3,4,5]. At 3 years, Black Caribbean children have higher risk, and Bangladeshis lower risk of asthma compared to White UK, linked to socio-economic and cultural factors[7]. In the US, young (≤ 3 yrs) African American children have excess asthma and respiratory illness compared to Whites[8,9]. Studies of asthma in very young children (< 3 yrs) are likely to include those with transient wheeze that might not persist later in childhood. There are no UK studies reporting and explaining ethnic differences in asthma in late childhood (11-13 yrs)

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