Regional and racial disparities in asthma hospitalizations in Mississippi

Background In the United States, asthma hospitalization rates are disproportionately high among blacks compared with other racial/ethnic groups and vary by geographic region. These disparities among asthma hospitalizations might be affected by social, environmental, and health-care access factors. Objective To determine demographic risk factors for asthma hospitalizations in urban versus rural areas of Mississippi. Methods A cross-sectional study using data from the Mississippi Asthma Surveillance System was conducted to compare asthma hospitalizations in the urban Jackson metropolitan statistical area and rural Delta regions of Mississippi from 2003 to 2005. Factors including race, sex, age, and household income that might be associated with multiple hospitalizations for asthma (3 or more during the study period) were assessed using logistic regression. Results Asthma hospitalization rates were significantly higher among all demographic groups in the rural Delta region compared with the urban Jackson Metropolitan Statistical Area ( P < .001). In both regions, hospitalization rates were higher among blacks and females ( P < .001). Asthma hospitalization rates were highest among children (0-17 years) and older adults (≥65 years). In both regions, blacks were more likely to have 3 or more asthma hospitalizations ( P < .001). Residents of the Delta had higher odds for multiple hospitalizations controlling for race, sex, age, and household income ( P < .05). Conclusion Blacks with asthma are more likely to have multiple asthma hospitalizations in Mississippi. Higher odds of multiple asthma discharges for Delta residents were not explained by race, sex, age, or income, indicating that other contributing factors (eg, environmental, social, and access to care factors) need further investigation.