Racial/Ethnic Disparity in the Incidence of Bronchiolitis Requiring Hospitalization

BACKGROUND: Race/ethnicity is currently not considered a risk factor for bronchiolitis, except for indigenous populations in western countries. A better understanding of the potential impact of race/ethnicity can inform programs, policy and practice related to bronchiolitis. METHODS: We performed a population-based longitudinal observational study using the State Inpatient Database from New York state in the United States. Infants born between 2009 and 2013 at term without comorbidities were followed for the first two years of life, up to 2015. We calculated the cumulative incidence among different race/ethnicity groups, and evaluated the risks by developing logistic regression models. RESULTS: Of 877 465 healthy term infants, 10 356 infants were hospitalized with bronchiolitis. The overall cumulative incidence was 11.8 per 1000 births. The cumulative incidences in non-Hispanic white, non-Hispanic black, Hispanic, and Asian infants were 8.6, 15.4, 19.1, and 6.5 per 1000 births, respectively. On multivariable analysis adjusting for socioeconomic status, the risks remained substantially high among non-Hispanic black (odds ratio [OR] 1.42, 95% confidence interval [CI]: 1.34-1.51) and Hispanic infants (OR 1.77, 95%CI: 1.67-1.87), whereas Asian race was protective (aHR 0.62, 95%CI: 0.56-0.69). CONCLUSIONS: The risks of bronchiolitis hospitalization in the first two years of life were substantially different by race/ethnicity, with Hispanic and black infants having highest rates of hospitalization. Further research is needed to develop and implement culturally appropriate public health interventions to reduce racial and ethnic health disparities in bronchiolitis.