Asthma morbidity measures across Black ethnic subgroups.

Area of Science:

• Pulmonary Medicine
• Health Disparities Research
• Epidemiology

Background:

• Black adults face disproportionately high asthma burdens.
• Existing research often treats Black populations as a monolithic group, overlooking crucial ancestral and cultural variations.
• Understanding these differences is vital for addressing asthma health disparities.

Purpose of the Study:

• To investigate whether asthma morbidity varies among different Black ethnic subgroups.
• To identify specific subgroups within the Black population experiencing higher asthma-related health issues.

Main Methods:

• The PREPARE trial recruited adults with moderate-to-severe asthma across the US and Puerto Rico.
• Participants were categorized into multiethnic Black (ME/B) and African American (AA/B) groups based on self-identification.
• Asthma morbidity, including exacerbations requiring systemic corticosteroids (SCs), emergency department/urgent care (ED/UC) visits, and hospitalizations, was compared using multivariable regression.

Main Results:

• ME/B participants were younger, more likely to reside in the US Northeast, speak Spanish, have lower BMI and health literacy, and fewer comorbidities but higher blood eosinophil counts compared to AA/B participants.
• ME/B individuals showed a significantly higher likelihood of ED/UC visits (IRR=1.34) and SC use (IRR=1.27) for asthma than AA/B individuals.
• Within the ME/B group, Puerto Rican Black Latinx participants had a significantly higher likelihood of ED/UC visits (IRR=1.64) and SC use (IRR=1.43) compared to AA/B participants. No significant differences in hospitalizations were observed.

Conclusions:

• Multiethnic Black adults, especially Puerto Rican Black Latinx individuals, exhibit an elevated risk for asthma-related emergency visits and systemic corticosteroid use.
• These findings highlight the heterogeneity within the Black population regarding asthma morbidity.
• Tailored interventions considering ethnic and cultural factors are necessary to effectively manage asthma in diverse Black communities.