Racial differences in physiologic parameters related to asthma among middle-class children

Chest. 2000 May;117(5):1336-44. doi: 10.1378/chest.117.5.1336.


Background: Asthma morbidity and mortality are higher in the United States for African-American (AA) children when compared to European-American (EA) children.

Study objectives: To explore racial differences in physiologic factors associated with pediatric asthma severity.

Design: Cross-sectional.

Methods: We analyzed data from two groups of children in suburban Detroit, one of which contains non-urban, middle-class AA children, a group not usually included in childhood asthma studies. All children were 6 to 8 years of age. Clinical evaluations included medical history, physical examination, skin testing, spirometry, and methacholine challenge.

Results: The study population (n = 569) was 14% African American, 51% of the participants were male, and the mean age was 6.8 +/- 0.4 years. Socioeconomic status (parental education) was similar overall by race, although some strata-specific differences were observed. The prevalence of physician-diagnosed asthma was 10% for both AA and EA groups. AA children were more reactive to methacholine than EA children (42% vs 22%, respectively; p = 0.001), and had significantly higher total IgE than EA children (geometric mean, 60. 6 vs 27.5 IU/mL; p = 0.001). Serum IgE was related to methacholine reactivity in EA children (p = 0.001), but not AA children (p = 0. 73). These differences remained after adjustment for gender, age, parental education, parental smoking, and maternal smoking during pregnancy.

Conclusions: Our data support previous reports of racial differences in lung volume, airway responsiveness, and serum IgE concentrations. We found a racial difference in the relationship between total serum IgE and airway responsiveness that is unreported elsewhere. Overall, our results suggest that AA children may be predisposed to asthma.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Asthma / ethnology*
  • Asthma / physiopathology
  • Black People*
  • Bronchial Hyperreactivity / ethnology*
  • Bronchial Hyperreactivity / physiopathology
  • Bronchial Provocation Tests
  • Child
  • Cross-Sectional Studies
  • Female
  • Forced Expiratory Volume / physiology
  • Humans
  • Immunoglobulin E / blood
  • Male
  • Methacholine Chloride
  • Michigan
  • Pregnancy
  • Respiratory Hypersensitivity / ethnology
  • Respiratory Hypersensitivity / physiopathology
  • White People*


  • Methacholine Chloride
  • Immunoglobulin E