Identification of population subgroups of children and adolescents with high asthma prevalence: findings from the Third National Health and Nutrition Examination Survey

Arch Pediatr Adolesc Med. 2002 Mar;156(3):269-75. doi: 10.1001/archpedi.156.3.269.


Objectives: To provide national estimates of asthma prevalence in African-American, Mexican American and white (non-Latino) children and adolescents using several common definitions; to evaluate familial, sociodemographic, and environmental risk factors that are independently associated with current asthma in children; and to identify subgroups at particular risk for current asthma using 2 complementary data analytic approaches.

Design: Cross-sectional study, using the Third National Health and Nutrition Examination Survey, 1988-1994.

Setting: Eighty-nine mobile examination centers in the United States.

Participants: Twelve thousand three hundred eighty-eight African American, Mexican American, and white (non-Latino) children and adolescents, aged 2 months through 16 years, selected from a systematic random, population-based, nationally representative sample.

Main outcome measure: Current asthma, defined by caregivers who reported that their child currently had doctor-diagnosed asthma.

Results: The overall prevalence of current asthma was 6.7% (95% confidence interval [CI], 5.6-7.8). Odds ratios for current asthma from the multiple regression analysis were 4.00 (95% CI, 2.90-5.52) for children with a parental history of asthma or hay fever, 1.94 (95% CI, 1.09-3.46) for children with body mass index (calculated as weight in kilograms divided by the square of height in meters) greater than or equal to the 85th percentile, and 1.64 (95% CI, 1.20-2.26) for children of African American ethnicity. African American and Mexican American children showed a consistent prevalence of current asthma across age while white children showed an increase in prevalence with age. The 2 highest-risk subgroups identified by the signal detection analysis were composed of children with a parental history of asthma or hay fever who were 10 years or older with a body mass index greater than or equal to the 85th percentile (31.0% current asthma), and children with a parental history who were 10 years or younger and of African American ethnicity (15.6% current asthma).

Conclusions: The findings from this analysis show a strong independent association between obesity and current asthma in children and adolescents, and confirm previous reports of a parental history of asthma or hay fever and African American ethnicity as additional important risk factors.

Publication types

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

MeSH terms

  • Adolescent
  • Age Distribution
  • Asthma / diagnosis
  • Asthma / ethnology*
  • Black or African American / statistics & numerical data*
  • California / epidemiology
  • Child
  • Child, Preschool
  • Cohort Studies
  • Confidence Intervals
  • Cross-Sectional Studies
  • Female
  • Health Surveys
  • Humans
  • Infant
  • Male
  • Mexican Americans / statistics & numerical data*
  • Odds Ratio
  • Prevalence
  • Regression Analysis
  • Risk Factors
  • Sex Distribution
  • White People / statistics & numerical data*