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* From the City of Chicago Department of Public Health.
Correspondence to: Sandra D. Thomas, MD, MS, Epidemiology Program, Chicago Department of Public Health, 333 S State St, Room 2136, Chicago, IL 60604; e-mail: sandrathomas{at}worldnet.att.net
Study objectives: To characterize the patterns and correlates of asthma hospitalizations and mortality in Chicago.
Design: Cross-sectional analysis of discharge data for 1996 and mortality time trend data for the period from 1990 to 1997.
Setting: The city of Chicago, IL, with Cook County, IL, and US data employed for comparisons.
Population studied: People who were hospitalized with a primary diagnosis of asthma and people whose underlying cause of death was asthma.
Interventions: None.
Measurements and results: The 1996 asthma hospitalization rate for Chicago was 42.8 per 10,000, more than twice as high as suburban Chicago or US rates. Medicaid patients were overrepresented. Length of stay was longer for older patients and Medicaid patients. Age-adjusted asthma mortality in Chicago was 4.7 times higher in non-Hispanic blacks than in non-Hispanic whites. The black/white asthma mortality ratio is 2.5:1 for the nation overall. Asthma mortality rates for Hispanics in Chicago were between those of non-Hispanic whites and blacks but have almost doubled during this decade.
Conclusions: The rising asthma mortality and high asthma hospitalization rates in Chicago constitute a significant public health problem. Comorbidities more common in urban environments, such as substance abuse, may play a unique role in determining the distribution of adverse outcomes within Chicago's population. Asthma hospitalizations and deaths may vary in their risk profiles, and this should be taken into account when developing research and intervention strategies.
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