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Findings From the Third National Health and Nutrition Examination Survey

Michael A. Rodríguez, MD, MPH; Marilyn A. Winkleby, PhD, MPH; David Ahn, PhD; Jan Sundquist, MD; Helena C. Kraemer, PhD

Arch Pediatr Adolesc Med. 2002;156:269-275.

Objectives  To provide national estimates of asthma prevalence in African-American, Mexican American and white (non-Latino) children and adolescents using several common definitions; to evaluate familial, sociodemographic, and environmental risk factors that are independently associated with current asthma in children; and to identify subgroups at particular risk for current asthma using 2 complementary data analytic approaches.

Design  Cross-sectional study, using the Third National Health and Nutrition Examination Survey, 1988-1994.

Setting  Eighty-nine mobile examination centers in the United States.

Participants  Twelve thousand three hundred eighty-eight African American, Mexican American, and white (non-Latino) children and adolescents, aged 2 months through 16 years, selected from a systematic random, population-based, nationally representative sample.

Main Outcome Measure  Current asthma, defined by caregivers who reported that their child currently had doctor-diagnosed asthma.

Results  The overall prevalence of current asthma was 6.7% (95% confidence interval [CI], 5.6-7.8). Odds ratios for current asthma from the multiple regression analysis were 4.00 (95% CI, 2.90-5.52) for children with a parental history of asthma or hay fever, 1.94 (95% CI, 1.09-3.46) for children with body mass index (calculated as weight in kilograms divided by the square of height in meters) greater than or equal to the 85th percentile, and 1.64 (95% CI, 1.20-2.26) for children of African American ethnicity. African American and Mexican American children showed a consistent prevalence of current asthma across age while white children showed an increase in prevalence with age. The 2 highest-risk subgroups identified by the signal detection analysis were composed of children with a parental history of asthma or hay fever who were 10 years or older with a body mass index greater than or equal to the 85th percentile (31.0% current asthma), and children with a parental history who were 10 years or younger and of African American ethnicity (15.6% current asthma).

Conclusions  The findings from this analysis show a strong independent association between obesity and current asthma in children and adolescents, and confirm previous reports of a parental history of asthma or hay fever and African American ethnicity as additional important risk factors.

From the Department of Family and Community Medicine, University of California, San Francisco (Dr Rodríguez); the Stanford Center for Research in Disease Prevention, Department of Medicine (Drs Winkleby, Ahn, and Sundquist); and the Department of Psychiatry (Dr Kraemer), Stanford University School of Medicine, Palo Alto, Calif. Dr Rodríguez is currently with the Department of Family Medicine, University of California, Los Angeles.

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