Chronic respiratory disease disparity between American Indian/Alaska Native and white populations, 2011-2018

• Published in: BMC public health 2021-07, Vol.21 (1), p.1466-8, Article 1466
• Main Authors: Laffey, Kimberly G, Nelson, Alfreda D, Laffey, Matthew J, Nguyen, Quynh, Sheets, Lincoln R, Schrum, Adam G
• Format: Article
• Language: English
• Subjects: Alaska Natives; American Indian or Alaska Native; American Indian/Alaskan Native; American Indians; Analysis; Asthma; Behavioral Risk Factor Surveillance System; BRFSS; Chronic illnesses; Chronic obstructive pulmonary disease; Chronic respiratory disease; Cross-Sectional Studies; Demographic aspects; Demographic variables; Demographics; Disease; Economic aspects; Economic indicators; Education; Ethnicity; Family income; Health aspects; Health care disparities; Health disparities; Health education; Health services; Hispanic people; Households; Humans; Income; Indians, North American; Indoor air quality; Lung diseases; Lung diseases, Obstructive; Marital status; Minority & ethnic groups; Morbidity; Native Americans; Obstructive lung disease; Polls & surveys; Population; Population studies; Populations; Public health; Regression analysis; Respiratory diseases; Risk analysis; Risk factors; Risk taking; Secondary schools; Sex education; Smoking; Social aspects; Social factors; Social services; Socioeconomic factors; Socioeconomic status; Socioeconomics; Surveillance; United States; Variables; Weight
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-021-11528-8

American Indian/Alaska Native (AI/AN) populations have been disproportionately affected by chronic respiratory diseases for reasons incompletely understood. Past research into disease disparity using population-based surveys mostly focused on state-specific factors. The present study investigates the independent contributions of AI/AN racial status and other socioeconomic/demographic variables to chronic respiratory disease disparity in an 11-state region with historically high AI/AN representation. Using data from the Behavioral Risk Factor Surveillance System (BRFSS) spanning years 2011-2018, this work provides an updated assessment of disease disparity and potential determinants of respiratory health in AI/AN populations. This cross-sectional study used data from the BRFSS survey, 2011-2018. The study population included AI/AN and non-Hispanic white individuals resident in 11 states with increased proportion of AI/AN individuals. The yearly number of respondents averaged 75,029 (62878-87,350) which included approximately 5% AI/AN respondents (4.5-6.3%). We compared the yearly adjusted prevalence for chronic respiratory disease, where disease status was defined by self-reported history of having asthma and/or chronic obstructive pulmonary disease (COPD). Multivariable logistic regression was performed to determine if being AI/AN was independently associated with chronic respiratory disease. Covariates included demographic (age, sex), socioeconomic (marital status, education level, annual household income), and behavioral (smoking, weight morbidity) variables. The AI/AN population consistently displayed higher adjusted prevalence of chronic respiratory disease compared to the non-Hispanic white population. However, the AI/AN race/ethnicity characteristic was not independently associated with chronic respiratory disease (OR, 0.93; 95% CI, 0.79-1.10 in 2017). In contrast, indicators of low socioeconomic status such as annual household income of