Effect of Relocation to the U.S. on Asthma Risk Among Hispanics

Am J Prev Med. 2017 May;52(5):579-588. doi: 10.1016/j.amepre.2016.12.018. Epub 2017 Feb 2.

Abstract

Introduction: Asthma prevalence is reportedly higher among U.S.-born relative to foreign-born Hispanics/Latinos. Little is known about rates of asthma onset before and after relocation to the U.S. in Latinos. Asthma rates were examined by U.S. residence and country/territory of origin.

Methods: In 2015-2016, age at first onset of asthma symptoms was analyzed, defined retrospectively from a cross-sectional survey in 2008-2011, in relation to birthplace and U.S. residence among 15,573 U.S.-dwelling participants (aged 18-76 years) in the Hispanic Community Health Study/Study of Latinos.

Results: Cumulative incidence of asthma through age 30 years ranged from 7.9% among Mexican background individuals to 29.4% among those of Puerto Rican background. Among those born outside the U.S. mainland, the adjusted hazard for asthma was 1.52-fold higher (95% CI=1.25, 1.85) after relocation versus before relocation to the U.S. mainland, with heterogeneity in this association by Hispanic/Latino background (p-interaction<0.0001). Among foreign-born Dominicans and Mexicans, rates of asthma were greater after relocation versus before relocation (adjusted hazard ratio [AHR] for after versus before relocation, 2.42, 95% CI=1.44, 4.05 among Dominicans; AHR=2.90, 95% CI=2.02, 4.16 among Mexicans). Puerto Ricans had modestly increased asthma onset associated with U.S. mainland residence (AHR=1.52, 95% CI=1.06, 2.17). No similar increase associated with U.S. residence was observed among Central/South American immigrants (AHR=0.94, 95% CI=0.53, 1.67). Asthma rates among Cuban immigrants were lower after relocation (AHR=0.45, 95% CI=0.24, 0.82).

Conclusions: The effect of relocation to the U.S. on asthma risk among Hispanics is not uniform across Hispanic/Latino groups.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Asthma / epidemiology
  • Asthma / ethnology*
  • Asthma / etiology
  • Cross-Sectional Studies
  • Emigrants and Immigrants / statistics & numerical data*
  • Emigration and Immigration / statistics & numerical data
  • Environment
  • Female
  • Health Surveys*
  • Hispanic Americans / statistics & numerical data*
  • Humans
  • Logistic Models
  • Male
  • Mexican Americans / statistics & numerical data
  • Middle Aged
  • Multivariate Analysis
  • Prevalence
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Assessment
  • Sex Distribution
  • United States / epidemiology
  • Young Adult