RACE AND GENDER DIFFERENCES IN RESPIRATORY ILLNESS PREVALENCE AND THEIR RELATIONSHIP TO ENVIRONMENTAL EXPOSURES IN CHILDREN 7 TO 14 YEARS OF AGE
RACE AND GENDER DIFFERENCES IN RESPIRATORY ILLNESS PREVALENCE AND THEIR RELATIONSHIP TO ENVIRONMENTAL EXPOSURES IN CHILDREN 7 TO 14 YEARS OF AGE
复制标题
DOI：
10.1164/ajrccm/148.1.10
复制
发表时间：
1993-07-01
期刊：
影响因子：
--
通讯作者：
DOCKERY, DW
中科院分区：
文献类型：
--
作者：
GOLD, DR;ROTNITZKY, A;DOCKERY, DW
对来自美国四个城市的8,322名白人儿童和1,056名7-14岁黑人儿童的呼吸系统疾病患病率的种族和性别差异进行了评估。男孩的喘息、哮喘、咳嗽、痰和支气管炎的发生率比女孩高。黑人儿童持续喘息、伴有喘息的气短、哮喘、慢性咳嗽和慢性痰的发生率高于白人儿童。我们研究了呼吸系统疾病患病率的种族差异是否可以用环境暴露和社会经济因素来解释。在没有父母的家庭中，黑人高中毕业的比例高于白人，单亲家庭的比例也是如此。黑人儿童吸烟的频率较低，他们的母亲吸烟也较少。个人和母亲吸烟预示着持续喘息、慢性咳嗽、慢性痰和胸部疾病的发生率更高。与不吸烟儿童相比，吸烟儿童持续喘息的相对几率为1.34(1.07，1.69)。母亲每天抽30支香烟的儿童与没有母亲吸烟的儿童相比，持续喘息的相对几率为1.35(1.13，1.60)。呼吸系统疾病的其他预测因素包括父母呼吸道疾病、父母教育、独生子女状况、单亲家庭、空调使用和体重指数。然而，对社会经济因素、环境暴露和身体习惯的调整并没有显著降低黑人儿童中观察到的过度呼吸道疾病的患病率。调整后的相对优势比为1.47(1.25，1.74)，黑人儿童与白人儿童哮喘的相对优势为1.57(1.17，2.10)。未测量的环境暴露或过敏易感性的人群差异可能是黑人和白人儿童呼吸道疾病发病率剩余差异的原因。
Race and gender differences in respiratory illness prevalence rates were assessed in a cohort of 8,322 white children and 1,056 black children 7 to 14 yr of age from four U. S. cities. Boys had higher rates of wheeze, asthma, cough, phlegm, and bronchitis than girls. Black children had higher rates of persistent wheeze, shortness of breath with wheeze, asthma, chronic cough, and chronic phlegm than white children. We examined whether the racial disparity in respiratory illness prevalence could be accounted for by environmental exposures and socioeconomic factors. The proportion of families without a parent who had graduated from high school was higher for blacks than for whites, as was the proportion of single-parent households. Black children took up smoking less frequently; their mothers smoked fewer cigarettes. Personal and maternal smoking predicted higher rates of persistent wheeze, chronic cough, chronic phlegm, and chest illness. The relative odds for persistent wheeze were 1.34 (1.07,1.69) for smoking children compared with nonsmoking children. The relative odds for persistent wheeze were 1,35 (1.13,1.60) for children whose mother smoked > 30 cigarettes per day versus children with no maternal smoke exposure. Other predictors of respiratory illnesses included parental respiratory illness, parental education, only-child status, single-parent household, air conditioner use, and body mass index. Nevertheless, adjustment for socioeconomic factors, environmental exposures, and body habitus did not significantly reduce the excess respiratory illness prevalence observed among black children. The adjusted relative odds were 1.47 (1.25, 1.74) for persistent wheeze and 1.57 (1.17, 2.10) for asthma for black children versus white children. Population differences in unmeasured environmental exposures or in predisposition to allergy may account for residual differences between black and white children in respiratory illness rates.