TY - JOUR
T1 - Pediatric asthma incidence rates in the United States from 1980 to 2017
AU - Children's Respiratory and Environmental Workgroup in the ECHO Consortium
AU - Johnson, Christine C.
AU - Havstad, Suzanne L.
AU - Ownby, Dennis R.
AU - Joseph, Christine L.M.
AU - Sitarik, Alexandra R.
AU - Biagini Myers, Jocelyn
AU - Gebretsadik, Tebeb
AU - Hartert, Tina V.
AU - Khurana Hershey, Gurjit K.
AU - Jackson, Daniel J.
AU - Lemanske, Robert F.
AU - Martin, Lisa J.
AU - Zoratti, Edward M.
AU - Visness, Cynthia M.
AU - Ryan, Patrick H.
AU - Gold, Diane R.
AU - Martinez, Fernando D.
AU - Miller, Rachel L.
AU - Seroogy, Christine M.
AU - Wright, Anne L.
AU - Gern, James E.
N1 - Funding Information:
The research reported in this article was supported by the Children's Respiratory and Environment Workgroup (CREW) consortium, which is part of National Institutes of Health (NIH) Environmental Influences on Child Health Outcomes (ECHO). CREW is funded by Health and Human Services/NIH grant 5UG3OD023282 (J.E.G.). Additional support was provided by the individual cohorts’ grants and contracts, which are as follows: Columbia University Center for Children's Environmental Health (CCCEH) (grants P01ES09600 [F.P.P.], R01 ES008977 [F.P.P.], P30ES09089 [R.S.], R01 ES013163 [R.L.M.], and R827027 [F.P.P.]); the Tucson Children's Respiratory Study (grant NHLBI 132523) (F.D.M./A.L.W.); the Infant Immune Study (grant AI-61811 [A.L.W.]); the Childhood Origins of Asthma Study (grants P01 HL070831 [R.F.L./D.J.J.], U10 HL064305 [R.F.L.], and R01 HL061879 [R.F.L.]); the Urban Environment and Childhood Asthma Study (grants NO1-AI-25496 [W.W.B.], NO1-AI-25482, HHSN272200900052C [W.W.B.], HHSN272201000052I, 1UM1AI114271-01 [W.W.B./D.J.J./J.E.G.], UM2AI117870, NCRR/NIH RR00052, M01RR00533, 1UL1RR025771 [D.M.C.], M01RR00071, 1UL1RR024156 [H.N.G.], UL1TR001079 [D.E.F.], 5UL1RR024992-02 [K.S.P.], and NCATS/NIH UL1TR000040 [H.N.G.]); the Cincinnati Childhood Allergy and Air Pollution Study (grants R01 ES11170 [G.K.L./G.K.H.] and R01 ES019890 [P.H.R.]); the Epidemiology of Home Allergens and Asthma Study (grant R01 AI035786) (D.R.G.); the Wayne County Health, Environment, Allergy and Asthma Longitudinal Study (grants R01 AI050681 [C.C.J.], R56 AI050681 [C.C.J.], R01 AI061774 [L.K.W.], R21 AI059415 [D.R.O.], K01 AI070606 [G.R.W.], R21 AI069271 [G.R.W.], R01 HL113010 [G.R.W.], R21 ES022321 [A.C.B.], P01 AI089473 [C.C.J./D.R.O.], R21 AI080066 [C.L.M.J.], R01 AI110450 [G.R.W.], and R01 HD082147 [A.C.B.]) and the Fund for Henry Ford Hospital (C.C.J./G.R.W./A.C.B.); and the Childhood Allergy Study (grants R01 AI024156 [D.R.O.]; R03 HL067427 [D.R.O.], and R01 AI051598 [E.M.Z.]); the Blue Cross Foundation (C.C.J.); and the Fund for Henry Ford Hospital (D.R.O./C.C.J./E.M.Z.).
Funding Information:
The research reported in this article was supported by the Children’s Respiratory and Environment Workgroup (CREW) consortium, which is part of National Institutes of Health (NIH) Environmental Influences on Child Health Outcomes (ECHO). CREW is funded by Health and Human Services / NIH grant 5UG3OD023282 (J.E.G.). Additional support was provided by the individual cohorts’ grants and contracts, which are as follows: Columbia University Center for Children's Environmental Health (CCCEH) (grants P01ES09600 [F.P.P.], R01 ES008977 [F.P.P.], P30ES09089 [R.S.], R01 ES013163 [R.L.M.], and R827027 [F.P.P.]); the Tucson Children’s Respiratory Study (grant NHLBI 132523) (F.D.M./A.L.W.); the Infant Immune Study (grant AI-61811 [A.L.W.]) ; the Childhood Origins of Asthma Study (grants P01 HL070831 [R.F.L./D.J.J.], U10 HL064305 [R.F.L.], and R01 HL061879 [R.F.L.]); the Urban Environment and Childhood Asthma Study (grants NO1-AI-25496 [W.W.B.], NO1-AI-25482, HHSN272200900052C [W.W.B.], HHSN272201000052I, 1UM1AI114271-01 [W.W.B./D.J.J./J.E.G.], UM2AI117870, NCRR/NIH RR00052, M01RR00533, 1UL1RR025771 [D.M.C.], M01RR00071, 1UL1RR024156 [H.N.G.], UL1TR001079 [D.E.F.], 5UL1RR024992-02 [K.S.P.], and NCATS/NIH UL1TR000040 [H.N.G.]); the Cincinnati Childhood Allergy and Air Pollution Study (grants R01 ES11170 [G.K.L./G.K.H.] and R01 ES019890 [P.H.R.]); the Epidemiology of Home Allergens and Asthma Study (grant R01 AI035786) (D.R.G.); the Wayne County Health, Environment, Allergy and Asthma Longitudinal Study (grants R01 AI050681 [C.C.J.], R56 AI050681 [C.C.J.], R01 AI061774 [L.K.W.], R21 AI059415 [D.R.O.], K01 AI070606 [G.R.W.], R21 AI069271 [G.R.W.], R01 HL113010 [G.R.W.], R21 ES022321 [A.C.B.], P01 AI089473 [C.C.J./D.R.O.], R21 AI080066 [C.L.M.J.], R01 AI110450 [G.R.W.], and R01 HD082147 [A.C.B.]) and the Fund for Henry Ford Hospital (C.C.J./G.R.W./A.C.B.); and the Childhood Allergy Study (grants R01 AI024156 [D.R.O.]; R03 HL067427 [D.R.O.], and R01 AI051598 [E.M.Z.]); the Blue Cross Foundation (C.C.J.); and the Fund for Henry Ford Hospital (D.R.O./C.C.J./E.M.Z.).
Publisher Copyright:
© 2021 American Academy of Allergy, Asthma & Immunology
PY - 2021/11
Y1 - 2021/11
N2 - Background: Few studies have examined longitudinal asthma incidence rates (IRs) from a public health surveillance perspective. Objective: Our aim was to calculate descriptive asthma IRs in children over time with consideration for demographics and parental asthma history. Methods: Data from 9 US birth cohorts were pooled into 1 population covering the period from 1980 to 2017. The outcome was earliest parental report of a doctor diagnosis of asthma. IRs per 1,000 person-years were calculated. Results: The racial/ethnic backgrounds of the 6,283 children studied were as follows: 55% European American (EA), 25.5% African American (AA), 9.5% Mexican-Hispanic American (MA) and 8.5% Caribbean-Hispanic American (CA). The average follow-up was 10.4 years (SD = 8.5 years; median = 8.4 years), totaling 65,291 person-years, with 1789 asthma diagnoses yielding a crude IR of 27.5 per 1,000 person-years (95% CI = 26.3-28.8). Age-specific rates were highest among children aged 0 to 4 years, notably from 1995 to 1999, with a decline in EA and MA children in 2000 to 2004 followed by a decline in AA and CA children in 2010 to 2014. Parental asthma history was associated with statistically significantly increased rates. IRs were similar and higher in AA and CA children versus lower but similar in EA and MA children. The differential rates by sex from birth through adolescence principally resulted from a decline in rates among males but relatively stable rates among females. Conclusions: US childhood asthma IRs varied dramatically by age, sex, parental asthma history, race/ethnicity, and calendar year. Higher rates in the 0- to 4-year-olds group, particularly among AA/CA males with a parental history of asthma, as well as changes in rates over time and by demographic factors, suggest that asthma is driven by complex interactions between genetic susceptibility and variation in time-dependent environmental and social factors.
AB - Background: Few studies have examined longitudinal asthma incidence rates (IRs) from a public health surveillance perspective. Objective: Our aim was to calculate descriptive asthma IRs in children over time with consideration for demographics and parental asthma history. Methods: Data from 9 US birth cohorts were pooled into 1 population covering the period from 1980 to 2017. The outcome was earliest parental report of a doctor diagnosis of asthma. IRs per 1,000 person-years were calculated. Results: The racial/ethnic backgrounds of the 6,283 children studied were as follows: 55% European American (EA), 25.5% African American (AA), 9.5% Mexican-Hispanic American (MA) and 8.5% Caribbean-Hispanic American (CA). The average follow-up was 10.4 years (SD = 8.5 years; median = 8.4 years), totaling 65,291 person-years, with 1789 asthma diagnoses yielding a crude IR of 27.5 per 1,000 person-years (95% CI = 26.3-28.8). Age-specific rates were highest among children aged 0 to 4 years, notably from 1995 to 1999, with a decline in EA and MA children in 2000 to 2004 followed by a decline in AA and CA children in 2010 to 2014. Parental asthma history was associated with statistically significantly increased rates. IRs were similar and higher in AA and CA children versus lower but similar in EA and MA children. The differential rates by sex from birth through adolescence principally resulted from a decline in rates among males but relatively stable rates among females. Conclusions: US childhood asthma IRs varied dramatically by age, sex, parental asthma history, race/ethnicity, and calendar year. Higher rates in the 0- to 4-year-olds group, particularly among AA/CA males with a parental history of asthma, as well as changes in rates over time and by demographic factors, suggest that asthma is driven by complex interactions between genetic susceptibility and variation in time-dependent environmental and social factors.
KW - Epidemiology
KW - IRs
KW - United States
KW - parental history
KW - pediatric asthma
KW - sex
KW - time
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UR - http://www.scopus.com/inward/citedby.url?scp=85108268130&partnerID=8YFLogxK
U2 - 10.1016/j.jaci.2021.04.027
DO - 10.1016/j.jaci.2021.04.027
M3 - Article
C2 - 33964299
AN - SCOPUS:85108268130
SN - 0091-6749
VL - 148
SP - 1270
EP - 1280
JO - Journal of Allergy and Clinical Immunology
JF - Journal of Allergy and Clinical Immunology
IS - 5
ER -
