Regional Differences in American Indian/Alaska Native Chronic Respiratory Disease Disparity: Evidence from National Survey Results

Kimberly G. Laffey (), Alfreda D. Nelson, Matthew J. Laffey, Quynh Nguyen, Lincoln R. Sheets and Adam G. Schrum
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Kimberly G. Laffey: Department of Molecular Microbiology and Immunology, School of Medicine, University of Missouri, Columbia, MO 65212, USA
Alfreda D. Nelson: Department of Surgery, School of Medicine, University of Missouri, Columbia, MO 65212, USA
Matthew J. Laffey: Institute for Data Science and Informatics, University of Missouri, Columbia, MO 65212, USA
Quynh Nguyen: Institute for Data Science and Informatics, University of Missouri, Columbia, MO 65212, USA
Lincoln R. Sheets: Department of Health Management and Informatics, School of Medicine, University of Missouri, Columbia, MO 65212, USA
Adam G. Schrum: Department of Molecular Microbiology and Immunology, School of Medicine, University of Missouri, Columbia, MO 65212, USA

IJERPH, 2024, vol. 21, issue 8, 1-8

Abstract: American Indian/Alaska Native (AI/AN) persons in the US experience a disparity in chronic respiratory diseases compared to white persons. Using Behavioral Risk Factor Surveillance System (BRFSS) data, we previously showed that the AI/AN race/ethnicity variable was not associated with asthma and/or chronic obstructive pulmonary disease (COPD) in a BRFSS-defined subset of 11 states historically recognized as having a relatively high proportion of AI/AN residents. Here, we investigate the contributions of the AI/AN variable and other sociodemographic determinants to disease disparity in the remaining 39 US states and territories. Using BRFSS surveys from 2011 to 2019, we demonstrate that irrespective of race, the yearly adjusted prevalence for asthma and/or COPD was higher in the 39-state region than in the 11-state region. Logistic regression analysis revealed that the AI/AN race/ethnicity variable was positively associated with disease in the 39-state region after adjusting for sociodemographic covariates, unlike in the 11-state region. This shows that the distribution of disease prevalence and disparity for asthma and/or COPD is non-uniform in the US. Although AI/AN populations experience this disease disparity throughout the US, the AI/AN variable was only observed to contribute to this disparity in the 39-state region. It may be important to consider the geographical distribution of respiratory health determinants and factors uniquely impactful for AI/AN disease disparity when formulating disparity elimination policies.

Keywords: American Indian/Alaska Native; disparity; respiratory disease; BRFSS; geographic variation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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