Study Shows ‘Striking Increase’ in Rates of Asthma Hospitalizations Among South Carolina African-American Youth

The rate at which African-American children were hospitalized for asthma at the Medical University of South Carolina has shown a "striking increase" between 1956 and 1997, according to a study in the December issue of Pediatrics. The study notes that the "most striking prevalence and morbidity of asthma in the United States" has been among black children, but "little research" has determined the scale of the problem or when asthma became so severe in that race and age group. To determine when the rise in hospitalizations for asthma among African Americans began and the pattern of asthma hospitalizations among various age and race groups, researchers reviewed charts of patients who were discharged from MUSC after being treated for asthma problems between 1956 and 1997. During that period, MUSC was the Charleston area's "primary inpatient" hospital for children and the only hospital for uninsured children. Overall, researchers found a "progressive increase" in hospitalizations for asthma among all African Americans. In addition, researchers identified an increase in asthma hospitalizations for both black and white patients under age 18. The largest increase, however, was among black children under age 18. The increase in asthma hospitalizations for black patients began around 1970 ("Asthma Hospitalization Trends in Charleston, South Carolina, 1956 to 1997: Twenty-fold Increase Among Black Children During a 30-Year Period," Pediatrics, December 2001). Between 1970 and 1997, the rate of black children discharged from MUSC after being treated for asthma problems rose from 18 children per 100,000 to 370 children per 100,000, a 20-fold increase (Smith, AP/Charlotte Observer, 12/3). For white patients, the increase in asthma hospitalizations occurred around 1980. Between 1980 and 1997, the asthma discharges for white patients increased five-fold ("Asthma Hospitalization Trends in Charleston, South Carolina, 1956 to 1997: Twenty-fold Increase Among Black Children During a 30-Year Period," Pediatrics, December 2001).

Explaining the Increases
According to lead researcher Dr. Dana Crater, there are "a number of theories" to explain the increase in asthma hospitalizations among black children, "but more study is needed" (AP/Charlotte Observer, 12/3). The study notes that "changes in lifestyle," less access to regular health care, living in crowded conditions and obesity might explain the increases. Other factors could include an increasing awareness of asthma, better acknowledgement from physicians or a change in admissions criteria, the study notes ("Asthma Hospitalization Trends in Charleston, South Carolina, 1956 to 1997: Twenty-fold Increase Among Black Children During a 30-Year Period," Pediatrics, December 2001). The study is available online.