In the United States, Puerto Ricans have higher asthma prevalence and have more morbidity and mortality from asthma than do whites, blacks, and other Hispanic subgroups. Using data from the National Health Interview Survey for from 1997 to 2001, Lara et al showed that Puerto Rican children had a higher lifetime prevalence of asthma (25.8%) than did white (12.7%), black (15.8%), Mexican (10.1%), Cuban (14.9%), and Dominican (14.9%) children living in the mainland United States. In addition, mainland Puerto Rican children had increased odds of an asthma attack in the past 12 months. According to the 2002 Behavioral Risk Factor Surveillance System the prevalence of current asthma was higher in adults living in Puerto Rico (11.6%) than in all US adults (7.3%) or Hispanic adults in the US mainland (5.5%). From 1990 to 1995, Puerto Ricans had the highest (40.9 per million) mortality rate due to asthma of all ethnic groups in the US mainland.
New evidence suggests that the effect of birthplace on asthma in Puerto Ricans is opposite that found for other ethnic groups. Lara et al found that although birth outside the United States protected Mexican, other Hispanic, and non-Hispanic white children from receiving a diagnosis of asthma, the lifetime risk of an asthma diagnosis was higher for island-born Puerto Rican children living in the mainland United States than for mainland-born Puerto Rican children. There are studies demonstrating high prevalence, morbidity, and mortality from asthma among Puerto Ricans living in Puerto Rico, but none comparing the prevalence of asthma and health-care utilization for asthma among Puerto Rican children living in Puerto Rico with the prevalence and health-care utilization for asthma among Puerto Rican children living in the mainland United States. The main purpose of this study was to compare the prevalence of asthma and lifetime hospitalization for asthma among Puerto Rican children in urban communities in the mainland United States (South Bronx, NY) and in Puerto Rico (San Juan and Caguas metropolitan areas). In spite of a previous report, we hypothesized that there would be a higher prevalence of asthma in Puerto Rican children living in the South Bronx than in those living in Puerto Rico, mainly because of the widespread poverty and overall living conditions among children in the South Bronx. A secondary purpose of this study was to examine potential factors that might explain differences between the two populations.