TRENDS IN THE PREVALENCE OF ASTHMA HOSPITALIZATION IN THE 5-YEAR-OLD TO 14-YEAR-OLD MICHIGAN MEDICAID POPULATION, 1980 TO 1986

Background: Despite advances in therapy, morbidity and mortality rates as a result of pediatric asthma appear to have increased during the p ast decade. Epidemiologic evidence suggests that these increases dispr oportionately affected black children and the urban poor. Methods: Wit h use of data from the Medicaid Management Information System, we esti mated the prevalence of asthma hospitalization in the 5- to 14-year-ol d Michigan Medicaid population for the period 1980 to 1986. Results: L arge increases were seen between 1980 and 1984, with leveling off or a slight decline thereafter. In 5- to 9-year-old children, the prevalen ce of asthma hospitalization increased from 2.3 per 1000 persons in 19 80 to 4.5 per 1000 in 1984. Ten- to 14-year-old children demonstrated an increase of 2.2 per 1000 in 1980 to 3.2 per 1000 in 1984. Comparabl e trends occurred in all strata defined by age, race, residency, and g ender. However, the largest increases were noted in urban black childr en, in which the rate more than doubled from 3.2 per 1000 in 1980 to 7 .1 per 1000 in 1984. The adjusted relative risk for asthma hospitaliza tion associated with being male was 1.6 (95% CI: 1.5, 1.7), with being black was 2.2 (95% CI: 2.1, 2.4), and with living in an urban county was 1.1 (95% CI: 1.04, 1.4). Conclusions: Within this relatively homog eneous low socioeconomic population, black race remained a strong pred ictor for asthma hospitalization, whereas urban residence was only min imally associated with this outcome.