Objectives. To better understand the prevalence of asthma among American In
dian and Alaska Native (Al/AN) children and to explore the contribution of
locale to asthma symptoms and diagnostic assignment, the authors surveyed A
l/AN middle school students, comparing responses from metropolitan Tacoma,
Washington (metro WA) and a non-metropolitan area of Alaska (non-metro AK).
Methods. Students in grades 6-9 completed an asthma screening survey. The a
uthors compared self-reported rates of asthma symptoms, asthma diagnoses, a
nd health care utilization for 147 children ages 11-16 self-reporting as Al
/AN in metro WA and 365 in non-metro AK.
Results. The prevalences of self-reported asthma symptoms were similar for
the metro WA and non-metro AK populations, but a significantly higher perce
ntage of metro WA than of non-metro AK respondents reported having received
a physician diagnosis of asthma (OR 2.33; 95% Cl 1.23, 4.39). The percenta
ges of respondents who reported having visited a medical provider for asthm
a-like symptoms in the previous year did not differ.
Conclusions. The difference in rates of asthma diagnosis despite similar ra
tes of asthma symptoms and respiratory-related medical visits may reflect d
ifferences in respiratory disease patterns, diagnostic labeling practices,
or environmental factors. Future attempts to describe asthma prevalence sho
uld consider the potential contribution of non-biologic factors such as dia
gnostic practices.