Race, Income, Urbanicity, and Asthma Hospitalization in California: Small Area AnalysisFinally, there was little difference in the asthma rates of hospitalization based on an area s urbanicity status (data not shown). Notably, blacks were dramatically more likely to be hospitalized for asthma whether they resided in an urban area or in a rural area compared with the other racial/ethnic cohorts. For example, urban vs rural asthma hospitalization rates for blacks were as follows: 109.2 vs 86.7/10,000 for children <5 years; 45.1 vs 44.6/10,000 for children 5 to 19 years; 18.3 vs 18.0/10,000 for adults 20 to 34 years; and 31.3 vs 37.9/10,000 for adults 35 to 64 years of age, respectively.
Results of the multivariate regression model shown in Table 3 adjust for the potential confounding effects of race/ethnicity, income, and urbanieity on asthma hospitalization rates in California. Overall, the age-specific models explained 32 to 58% of the total variation in asthma hospitalization rates statewide. In general, only two ecologic predictors, median household income and the percentage of the population that was black, were significant in explaining the geographic variation in asthma hospitalization rates across California within each age group. For the youngest age group, an area’s asthma hospitalization rate increased by 3.6% and 1.6% with an associated 10% increase in the proportion of black and Asian residents, respectively. The percentage of the population that was Hispanic and the urbanicity status of an area were not found to be significant predictors in any of the age-specific models. Finally, in each age-specific model, the addition of an interaction term for median household income and percent black was not significant, suggesting that the influence of black race on asthma hospitalization rates is independent of income. canadian neightbor pharmacy

Bicoastal Comparison
Using published data for New York City, a bicoastal comparison of asthma hospitalization rates was conducted. Among persons aged 0 to 34 years, New York City residents were hospitalized for asthma 2.8 times more frequently than their Los Angeles counterparts. The average asthma hospitalization rate among New York City residents was 39/10,000 (95% confidence intent!, 21 to 115/10,000) between 1982 and 1986. By comparison, the average rate of asthma hospitalization among Los Angeles residents 0 to 34 years reported in this study was 14/10,000 in 1993. New York City children <5 years were hospitalized 2.3 times more frequently than their Los Angeles counterparts (102 vs 44/ 10,000, respectively). Important differences were found when comparing bicoastal asthma rates of hospitalization by race/ethnicity. Asthma hospitalization rates among black residents of Los Angeles and New York City were similar: 60 vs 40/10,000, respectively. In contrast, asthma hospitalization rates were 4.5 times higher among Hispanics in New York City (primarily of Puerto Rican origin) vs Hispanics in Los Angeles (primarily of Mexican-American origin) (63 vs 14/10,000, respectively). It appears that the higher rates among Puerto Ricans contributed most significantly to the increased rate of asthma hospitalization found in New York City.
Table 3—Results of Regression Analysis for Asthma Hospitalizations in California in 1993

Age Group, yr Independent Variable Parameter Estimate (SE) % Change in Asthma Hospitalization*(95% Cl)
<5 Median income -0.38 (0.26) NS
Urbanicity 0.14 (0.15) NS
(r2=0.58) % Population black 0.36f (0.05) 3.6% (2.6%, 4.6%)
(F value = 14.32f) % Population Hispanic 0.002 (0.06) NS
% Population Asian 0.16* (0.07) 1.6% (0.2%, 3.0%)
5-19 Median income -0.73′ (0.29) -7.3% (-13.0%, -1.6%)
Urbanicity -0.01 (0.17) NS
(r2—0.49) % Population black 0.30′ (0.06) 3.0% (1.8%, 4.2%)
(F value=9.96f) % Population Hispanic -0.02 (0.07) NS
% Population Asian 0.12 (0.08) NS
20-34 Median income -0.46 (0.29) NS
Urbanicity -0.17 (0.17) NS
(r2=0.32) % Population black 0.19′ (0.06) 1.9% (0.7%, 3.0%)
(F value=4.79*) % Population Hispanic -0.11 (0.07) NS
% Population Asian -0.09 (0.08) NS
35-64 Median income -0.91′ (0.24) -9.1% (-13.8%, -4.4%)
Urbanicity -0.03 (0.14) NS
(r2=0.51) % Population black 0.22′ (0.05) 2.2% (1.2%, 3.2%)
(F value = 10.53t) % Population Hispanic —0.02 (0.06) NS
% Population Asian -0.008 (0.07) NS