Published ahead of print on October 6, 2005, doi:10.1164/rccm.200508-1232SO
Am. J. Respir. Crit. Care Med., Volume 173, Number 2, January 2006, 143-163
A more recent version of this article appeared on January 15, 2006
Submitted on August 9, 2005
Accepted on October 5, 2005
State of the Art: Asthma in Hispanics
Gary M Hunninghake1, Scott T Weiss2, and Juan C Celedon3*
1 Department of Medicine, Channing Laboratory, Brigham and Women's Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA,
2 Department of Medicine, Channing Laboratory, Brigham and Women's Hospital, Boston, MA, USA; Respiratory Disorders Program, Brigham and Women's Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA,
3 Department of Medicine, Channing Laboratory, Brigham and Women's Hospital, Boston, MA, USA; Respiratory Disorders Program, Brigham and Women's Hospital, Boston, MA, USA; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
* To whom correspondence should be addressed. E-mail: juan.celedon{at}channing.harvard.edu.
Hispanic individuals trace their ancestry to countries that were previously under Spanish rule, including Mexico, large parts of Central and South America, and some Caribbean islands. Most -but not all- Hispanics have variable proportions of European, Amerindian, and African ancestry. Hispanics are diverse with regard to many factors, including racial ancestry, country of origin, area of residence, socioeconomic status, education, and access to healthcare. Recent findings suggest that there is marked variation in the prevalence, morbidity, and mortality of asthma in Hispanics in the United States and in Hispanic America. The reasons for differences in asthma and asthma morbidity among and within Hispanic subgroups are poorly understood but are likely due to the interaction between yet-unidentified genetic variants and other factors, including environmental tobacco smoke exposure, obesity, allergen exposure, and availability of healthcare. Barriers to optimal management of asthma in Hispanics in the U.S. and in Hispanic America include inadequate access to healthcare, suboptimal use of antiinflammatory medications, and lack of reference values for spirometric measures of lung function in many sub-groups (e.g., Puerto Ricans). Future studies of asthma in Hispanics should include large samples of subgroups that are well characterized with regard to self-reported ethnicity, country of origin, place of birth, area of residence, and indicators of socioeconomic status. Because Hispanics are disproportionately represented among the poor in the United States, implementation of adequate access to healthcare and social reforms (e.g., improving housing conditions) would likely have a major impact on reducing asthma morbidity in this population.
Key words: asthma, Hispanics, genetics, risk factors
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