Chest
Volume 116, Supplement 2, October 1999, Pages 135S-141S
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Asthma Hospitalizations and Mortality in Chicago: An Epidemiologic Overview

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Design

Cross-sectional analysis of discharge data for 1996 and mortality timetrend data for the period from 1990 to 1997.

Setting

The city of Chicago, IL, with Cook County, IL, and US data employed forcomparisons.

Population studied

People who werehospitalized with a primary diagnosis of asthma and people whoseunderlying cause of death was asthma.

Interventions

None.

Measurements and results

The 1996 asthmahospitalization rate for Chicago was 42.8 per 10,000, more than twiceas high as suburban Chicago or US rates. Medicaid patients wereoverrepresented. Length of stay was longer for older patients and Medicaid patients. Age-adjusted asthma mortality in Chicago was 4.7times higher in non-Hispanic blacks than in non-Hispanic whites. Theblack/white asthma mortality ratio is 2.5:1 for the nation overall. Asthma mortality rates for Hispanics in Chicago were between those of non-Hispanic whites and blacks but have almost doubled during thisdecade.

Conclusions

The rising asthma mortality andhigh asthma hospitalization rates in Chicago constitute a significantpublic health problem. Comorbidities more common in urban environments, such as substance abuse, may play a unique role in determining thedistribution of adverse outcomes within Chicago's population. Asthmahospitalizations and deaths may vary in their risk profiles, and thisshould be taken into account when developing research and interventionstrategies.

Section snippets

Study Populations

The primary study population comprised residents of Chicago, IL, which is located in Cook County. For comparison purposes, data were also obtained when appropriate for suburban residents of Cook County, IL, and the US population.

Data Sources

Hospitalization data for Chicagoans and non-Chicago residents of Illinois were obtained from the 1996 Research-Oriented Data Set of the Illinois Health Care Cost Containment Council (IHCCCC) in Springfield, IL. The IHCCCC collects and disseminates information on

Hospitalizations

In 1996, there were 11,926 asthma hospitalizations in Illinois for Chicago residents, or 42.8 per 10,000 population. This is more than twice the hospitalization rate for asthma in 19954 for the United States (19.5) and in 1996 for suburban Cook County (18.5 per 10,000). Most Chicago residents were hospitalized within the city (87.7%) or suburban Cook County (12.2%).

In a pattern similar to national data,4 hospitalizations for Chicago residents showed a complex relationship with age, as shown in

Discussion

We have attempted in our analyses to provide a comprehensive perspective on two topics, asthma-related hospitalization and mortality, that could each be the subject of lengthier investigations. In expanding both the breadth and the depth of prior publications based on Chicago-specific data, we have identified some common underlying themes and some notable differences.

Although Chicago has a higher asthma hospitalization rate than the nation overall, we were unable to detect evidence for unique

Conclusion

Asthma is a significant and growing public health concern for Chicago, particularly for African Americans. Comorbidities more common in urban environments, such as substance abuse, may play a unique role in determining the distribution of adverse outcomes within the population. Different adverse asthma outcomes may vary in their risk profiles, and this should be taken into account when developing research and intervention strategies. Current data sources are not adequate to answer some

ACKNOWLEDGMENTS

The authors thank Cristopher Lyttle for his assistance with the IHCCCC data set, and Cristal Simmons for her assistance with the poverty data.

References (25)

  • Metro Chicago Information Center
  • LW Wissow et al.

    Poverty, race, and hospitalization for childhood asthma

    Am J Public Health

    (1988)
  • Cited by (0)

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