Asthma and bronchiolitis hospitalizations among American Indian children

Objective: To compare asthma and bronchiolitis hospitalization rates in American Indian and Alaskan native (AI/AN) children and all children in Washington State. Methods: A retrospective data analysis using Washington State hospitalization data for 1987 through 1996. Patients were included if asthma or bronchiolitis was the first-listed diagnosis. American Indian and Alaskan native children were identified by linking state hospitalization data with Indian Health Service enrollment data. Results: Similar rates of asthma hospitalization were found for AI/AN children older than 1 year compared with all children. In AI/AN children younger than 1 year, hospitalization rates for asthma (528 per 100 000 population; 95% confidence interval [CI], 346-761) and bronchiolitis (2954 per 100 000 population; 95% CI, 2501- 3456) were 2 to 3 times higher than the rates in all children (232 per 100 000 population [95% CI, 215-251] and 1190 per 100 000 population [95% CI, 1149-1232], respectively). Hospitalization rates for asthma and bronchiolitis increased 50% between 1987 and 1996 for all children younger than I year and almost doubled for AI/AN children younger than 1 year. Conclusions: American Indian and Alaskan native children have significantly higher rates of hospitalization for wheezing illnesses during the first year of life compared with children of other age groups and races. Furthermore, the disparities in rates have increased significantly over time. Future public health measures directed at managing asthma and bronchiolitis should target AI/AN infants.