Ethnic Differences In Childhood Respiratory Health: Findings From The Millennium Cohort Study (Abstract)

Background: It is not clear how respiratory morbidity during infancy and early childhood varies across ethnic groups in the UK. This study sought to determine whether reported contact with health services due to respiratory problems during infancy differed across ethnic groups and whether patterns persisted or changed during early childhood. Methods: Data from the UK Millennium Cohort Study on 18 496 infants were analysed. Parental interviews were conducted when the cohort member was aged approximately 9 months (sweep 1) and 3 years (sweep 2). Questions included contact with primary care services or hospital admissions for respiratory problems (sweep 1), and the occurrence of respiratory symptoms (sweep 2). Results: 6.4% of all infants (n = 1178) had contact with primary care services because of asthma or wheezing. Black Caribbean infants were more likely (11.7%) and Indian infants less likely (3%) to have contact with primary care services compared with whites (6.9%). Pakistani infants were more likely (2.1%) to be admitted to hospital than whites (0.8%). These differences remained after adjustment for biopsychosocial factors for black Caribbean (odds ratio (OR) = 1.96 (95% confidence interval, 1.21 to 3.18)) but lost statistical significance for Indian infants (OR = 0.48 (0.18 to 1.23)). The proportion of hospital admissions was low (0.9% of sample, n = 164). At age 3, 12.3% (n = 1902) of children had ever had asthma and 20.0% (n = 3030) had wheezed in the past 12 months. Black Caribbean children (18.2%) were more likely and Bangladeshi children (5.0%) less likely than white children (11.6%) to have ever had asthma. Black Caribbean children were more likely (25.5%) and Indian (16.9%) and Bangladeshi children (8.7%) less likely to have had recent wheeze than white children (19.4%). After adjustments, the disadvantage in asthma and recent wheeze for black Caribbeans was mostly explained by socioeconomic factors (asthma, OR = 1.42 (0.96 to 2.09); recent wheeze, OR = 1.18 (0.85 to 1.64)). The Bangladeshi advantage was largely unexplained by our models, although statistical significance was lost (asthma, OR = 0.40 (0.15 to 1.09); recent wheeze, OR = 0.44 (0.18 to 1.09)). The Indian advantage was mainly explained by cultural factors (recent wheeze, OR = 1.04 (0.66 to 1.63)). Conclusions: Differences exist in health care contact for respiratory problems across ethnic groups during infancy, and these are not explained by a range of known risk factors. Early childhood disadvantage in respiratory morbidity among the black Caribbean groups is due to socioeconomic factors whereas the apparent advantage of some South Asian groups remains mostly unexplained