Multiracial adults face elevated asthma prevalence

Key takeaways:

• Lifetime asthma prevalence was 32.3% in Black-white adults vs. 20.9% in monoracial Black adults and 16.3% in monoracial white adults.
• American Indian/Alaska Native-multiple adults also had elevated prevalence.

Among adults in California, those who identified as multiracial had greater lifetime and current asthma prevalences vs. the monoracial populations they shared identities with, according to results published in JAMA Network Open.

“To me, the biggest contribution of this study is the very detailed disaggregation of data within the multiracial population,” Tracy Lam-Hine, DrPH, MBA, postdoctoral scholar in the department of epidemiology and population health at Stanford Medicine, told Healio.

In a cross-sectional study, Lam-Hine and colleagues evaluated 88,201 adults (48.6% women; 4.1% missing sex data) who completed the California Behavioral Risk Factor Surveillance Survey between 2014 and 2022 to determine how lifetime and current prevalences of asthma differ between monoracial groups and multiracial groups.

A diagnosis of asthma was observed in 14.2% of the entire population, but a smaller proportion of adults still had asthma (8.4%), according to researchers.

A large proportion of adults identified as white (39%), with fewer adults identifying as Asian (15.4%), Black (5.5%), multiracial (2%), American Indian/Alaska Native (0.6%) and Native Hawaiian/Pacific Islander (0.3%). Race was unknown for 1.9% of the population.

Adults who identified as American Indian/Alaska Native-multiple had a heightened lifetime asthma prevalence at 33.5%, and researchers noted that this could also be said for adults who identified as Black-white (32.3%) and American Indian/Alaska Native-Black (30.4%).

The same racial/ethnic categories had elevated current asthma prevalences, with a prevalence of 29.5% in the American Indian/Alaska Native-multiple group, 21.9% in the American Indian/Alaska Native-Black group and 18.9% in the Black-white group, according to the study.

Notably, researchers found that the above populations vs. the monoracial populations they shared identities with had greater prevalences of lifetime and current asthma.

“Our findings help complicate the idea that the health of multiracial people can be expected to reflect an ‘average’ of the monoracial groups they share identities with,” Lam-Hine told Healio. “By that thinking, we’d expect to see asthma rates for biracial Black-white people to fall somewhere between the rates for monoracial Black and monoracial white people, but our data show that the rates for this subgroup (and several other multiracial subgroups) is much higher than the rates for either of those two monoracial groups.”

For monoracial Black adults, the study reported lifetime and current asthma prevalences of 20.9% and 13.2%, and for monoracial white adults, these prevalences were 16.3% and 10%.

“This suggests there may potentially be unmeasured social factors that put multiracial people at disproportionate risk of asthma. We need more health research that integrates findings from social sciences research on the unique stressors multiracial people in the U.S. face,” Lam-Hine said.

Among adults of any race who identified as Hispanic (35.2%), Asian-Hispanic adults had the greatest lifetime asthma prevalence at 23.2%, followed closely by Black-Hispanic-white adults at 21% and Hispanic-Pacific Islander adults at 20.6%.

Researchers reported that the same groups also had heightened current asthma prevalences, with a prevalence of 19% in the Hispanic-Pacific Islander group, 18.9% in the Black-Hispanic-white group and 15% in the Asian-Hispanic group.

The three racial/ethnic groups with the smallest lifetime asthma prevalences included adults who identified as Asian other than Asian Indian, Chinese, Filipino, Japanese, Korean or Vietnamese (5.6%), Puerto Rican (7%) and Korean (7.3%).

Small current asthma prevalences were also observed in these populations (Korean, 2.6%; “Other Asian,” 2.9%; Puerto Rican, 4.4%), according to the study.

For more information:

Tracy Lam-Hine, DrPH, MBA, can be reached at lamhine@stanford.edu.