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JACI Highlights - August 2009Unexpected finding for Puerto Ricans in asthma disparities researchPuerto Ricans have been presumed to have severe asthma on the basis of prevalence rates and health care utilization data, with higher prevalence rates found on island Puerto Rico than on the mainland. In a study of asthma disparities funded by the National Heart, Lung and Blood Institute (NHLBI), Esteban et al. characterized differences in asthma severity and control among four groups of children (Puerto Ricans living in island Puerto Rico and Puerto Ricans, Dominicans, and non-Latino whites living in Rhode Island [RI]) using published guidelines and including direct clinical observation of participants. Puerto Ricans in their island sample had milder asthma severity than expected and asthma control rates similar to RI whites based on symptom frequency and pulmonary function. RI Puerto Ricans tended toward lower asthma control than their island counterparts, and RI Dominicans had the lowest level of control. Paradoxically, island Puerto Ricans reported more ED visits in the past year than the three RI groups. Potential reasons for these paradoxical findings and areas for future research are discussed, such as practice policies of the Puerto Rican health care system and varying cultural norms. The article also explores limitations of current guidelines for rating asthma severity and control in the context of disparate groups. “Conundrums in Childhood Asthma Severity, Control, and Healthcare Utilization between Puerto Rico and Rhode Island” by Esteban et al. (JACI August 2009 Volume 124 No. 2) |
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