AAPI Nexus: Policy, Practice and Community

Little is known about childhood asthma rates and severity in the Asian American population in the US. We screened convenience samples of recent Chinese immigrants and longtime Asian Americans using the Brief Pediatric Asthma Screen (BPAS) in Boston Chinatown. Our goal was to conduct an exploratory study that helped develop methodology for researching asthma in Chinese immigrant populations. About 15% of the children surveyed were reported to have doctor-diagnosed asthma. Over 18% had possible undiagnosed asthma as scored via a modification to the BPAs that was likely to increase responses consistent with undiagnosed asthma. The CDC estimates that 8.7% of children have a lifetime diagnosis of asthma. Studies examining asthma in children have consistently found that asthma rates are higher among children living in urban communities of color, which is reflected in this study’s findings. The only statistically significant predictor of asthma diagnosis in a logistic regression model was taking the survey in Chinese (p<0.001; R=0.62) suggesting that acquisition of English is an important factor. We note that there are difficulties associated with translation of the word “wheeze” into Chinese and discuss the problems associated with this key term in the BPAS. Finally we report data from a separate survey of housing conditions in Boston Chinatown. Housing conditions known or suspected to aggravate asthma were reported by respondents to be infrequent. More research is needed to distinguish true difference in prevalence from differential diagnosis of asthma.