A23-21 Racial Disparities in Risk Factors for COPD and Asthma Hospitalizations in the United States, 2016-2021

Abstract Rationale Chronic obstructive pulmonary disease (COPD) and asthma are the two most common obstructive airway diseases in the United States and both impose a significant health and economic burden. COPD ranks as the sixth leading cause of death nationwide and costs approximately 24 billion annually, while asthma costs approximately 81 billion. Prior studies have shown that Black patients have higher risks of pulmonary-related hospitalizations compared to non-Hispanic Whites. However, research examining the underlying risk factors behind these disparities and how they vary across major racial groups is limited. Methods We conducted a cross-sectional analysis using 2016-2021 data from the National Inpatient Sample (NIS). Race was categorized as White, Black, Hispanic, Asian/Pacific Islander, or Other. The study cohort included adults aged 18 and older with COPD or asthma-related hospitalizations as a primary diagnosis identified using ICD-10-CM codes. Other comorbid conditions were identified in secondary diagnosis positions. We excluded patients under 18 and all dental, perinatal, and pregnancy-related hospitalizations. Race-stratified multivariable logistic regression models were fitted to examine differences in key demographic and clinical risk factors for pulmonary hospitalizations. Results A total of 665, 839 adults with either COPD or asthma were identified. Age was the strongest predictor of pulmonary hospitalizations across all racial groups (aOR range: 1. 93-3. 97). Being male was protective among White (aOR 0. 70, 95% CI 0. 69-0. 70), Black (aOR 0. 65, 95% CI 0. 65-0. 66), and Hispanic (aOR 0. 64, 95% CI 0. 62-0. 65) patients, but associated with increased risk among Asian/Pacific Islander patients (aOR 1. 09, 95% CI 1. 04-1. 14). Socioeconomic factors, such as higher income (aOR range: 0. 70-0. 94) and private insurance (aOR range: 0. 59-0. 76), were protective across all racial groups. Comorbid pneumonia (aOR range: 1. 69-2. 62) and nicotine/tobacco use (aOR range: 1. 78-2. 59) increased risk of pulmonary hospitalization. Conclusions This study aims to deepen understanding of disparities in respiratory health outcomes across the United States with a focus on race and other risk factors. Our findings help lay the groundwork for future research and ultimately inform targeted interventions to reduce pulmonary morbidity and address inequities. This abstract is funded by: None