Race/ethnicity, language, and asthma care: findings from a 4-state survey.

BACKGROUND: Latino and African American children have poorer asthma control than non-Latino white children, but few studies examine the association among race/ethnicity, language, and specific processes of asthma care.
OBJECTIVE: To evaluate the association of race/ethnicity and language with the quality of asthma care.
METHODS: A random sample of children from birth to the age of 17 years with asthma within 4 states (California, Texas, Illinois, and Alabama) was selected for the National Asthma Survey conducted by the National Center for Health Statistics from March 1, 2003, to March 10, 2004. Parents completed a telephone survey that included measures of asthma care quality. The final sample was 1,517 children.
RESULTS: According to parental report, only 41.4% of children had an asthma management plan and 48.5% were ever advised by a clinician to control asthma by changing the child's home and school environment. African American and Latino children with persistent asthma had lower odds of taking controller medication than non-Latino white children. In multivariate analysis adjusting for annual income, insurance, and age, Latino children with Spanish parental interview, but not African American and Latino children with English parental interview, had poorer experiences with care than white children (ever taught what to do during an attack: odds ratio, 0.4 [95% confidence interval, 0.2-0.6]; and ever advised to change child's home and school environment: odds ratio, 0.5 [95% confidence interval, 0.3-0.8]).
CONCLUSIONS: Differences in asthma care quality and controller use persist among racial/ethnic and language groups despite similar rates of planned encounters for asthma. Improving use of controller medications and counseling on environmental modifications are important for reducing asthma disparities.