Association between birthplace, prevalence, and age of asthma onset in adults: A United States population-based study

Jonathan I. Silverberg*, Helen G. Durkin, Rauno Joks

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Results: Adults born outside the United States had lower odds of ever asthma (adjusted odds ratio [OR] 0.52,95% confidence interval [CI] 0.49e0.55) or current asthma (OR 0.50, 95% CI, 0.46e0.54). The inverse associationbetween foreign birthplace and asthma prevalence was significant in all regions of birth (P < .0001).Adults born outside the United States who resided in the United States for longer than 10 years comparedwith only 0 to 4 years had higher odds of ever asthma (OR 1.28, 95% CI, 1.18e1.38) and current asthma (OR1.70, 95% CI, .31e2.19). Foreign-born compared with US-born adults also had delayed onset of asthma(adjusted hazard ratio 0.27, 95% CI, 0.27e0.28). The US prevalence of asthma increased in a linear mannerfrom 1997 (9.1%, 8.77%e9.37%) to 2011 (12.5%, 12.1%e12.8%, P < .0001), which paralleled the trend forUS-born adults. However, the prevalence of asthma in foreign-born adults was consistently lower andincreased to a lesser extent (P < .0001).

Conclusion: Foreign-born American adults from all regions of birth have a lower prevalence of asthma,which increases after prolonged US residency. Foreign-born Americans may have a higher risk of adult-onsetasthma.

Methods: Data from 447,801 adults from the 1997 to 2011 National Health Interview Survey were reviewed.History of asthma was compared with birthplace using Rao-Scott c2 tests, survey logistic, propensity score,and Cox regression. Trends of asthma prevalence were analyzed using logistic regression. Multivariatemodels controlled for sociodemographics, health care access, smoking history, and body mass index.

Background: Previous studies have found associations between region of birth and asthma prevalence.

Objective: To study the association among birthplace, US prevalence, age of onset, and disease course ofadult asthma.

Original languageEnglish (US)
Pages (from-to)410-417.e1
JournalAnnals of Allergy, Asthma and Immunology
Issue number4
StatePublished - Oct 1 2014

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Pulmonary and Respiratory Medicine

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