Deidre Crocker1, Clive Brown2, Ronald Moolenaar3, Jeanne Moorman4, Cathy Bailey4, David Mannino5, Fernando Holguin6. 1. Air Pollution and Respiratory Health Branch, Centers for Disease Control and Prevention, Atlanta GA. Electronic address: dvj4@cdc.gov. 2. Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta GA. 3. Division of Global Public Health Capacity Development, Centers for Disease Control and Prevention, Atlanta GA. 4. Air Pollution and Respiratory Health Branch, Centers for Disease Control and Prevention, Atlanta GA. 5. Division of Pulmonary and Critical Care Medicine, University of Kentucky, Lexington KY. 6. Department of Medicine, University of Pittsburgh, Pittsburgh, PA.
Abstract
BACKGROUND: Despite the availability of effective treatment, minority children continue to experience disproportionate morbidity from asthma. Our objective was to identify and characterize racial and ethnic disparities in health-care utilization and medication usage among US children with asthma in a large multistate asthma survey. METHODS: We analyzed questions from the 2003-2004 four-state sample of the National Asthma Survey to assess symptom control, medication use, and health-care utilization among white, black, and Hispanic children < 18 years old with current asthma who were residing in Alabama, California, Illinois, or Texas. RESULTS: Of the 1,485 children surveyed, 55% were white, 25% were Hispanic, and 20% were black. Twice as many black children had asthma-related ED visits (39% vs 18%, respectively; p < 0.001) and hospitalizations (12% vs 5%, respectively; p = 0.02) compared with white children. Significantly fewer black and Hispanic children reported using inhaled corticosteroids (ICSs) in the past 3 months (21% and 22%, respectively) compared to white children (33%; p = 0.001). Additionally, 26% of black children and 19% of Hispanic children reported receiving a daily dose of a short-acting beta-agonist compared with 12% of white children (p = 0.001). ED visits were positively correlated with short-acting beta-agonist use and were negatively correlated with ICS use when stratified by race/ethnicity. CONCLUSIONS: Children with asthma in this large, multistate survey showed a dramatic underuse of ICSs. Black and Hispanic children compared with white children had more indicators of poorly controlled asthma, including increased emergency health-care utilization, more daily rescue medication use, and lower use of ICSs, regardless of symptom control.
BACKGROUND: Despite the availability of effective treatment, minority children continue to experience disproportionate morbidity from asthma. Our objective was to identify and characterize racial and ethnic disparities in health-care utilization and medication usage among US children with asthma in a large multistate asthma survey. METHODS: We analyzed questions from the 2003-2004 four-state sample of the National Asthma Survey to assess symptom control, medication use, and health-care utilization among white, black, and Hispanic children < 18 years old with current asthma who were residing in Alabama, California, Illinois, or Texas. RESULTS: Of the 1,485 children surveyed, 55% were white, 25% were Hispanic, and 20% were black. Twice as many black children had asthma-related ED visits (39% vs 18%, respectively; p < 0.001) and hospitalizations (12% vs 5%, respectively; p = 0.02) compared with white children. Significantly fewer black and Hispanic children reported using inhaled corticosteroids (ICSs) in the past 3 months (21% and 22%, respectively) compared to white children (33%; p = 0.001). Additionally, 26% of black children and 19% of Hispanic children reported receiving a daily dose of a short-acting beta-agonist compared with 12% of white children (p = 0.001). ED visits were positively correlated with short-acting beta-agonist use and were negatively correlated with ICS use when stratified by race/ethnicity. CONCLUSIONS:Children with asthma in this large, multistate survey showed a dramatic underuse of ICSs. Black and Hispanic children compared with white children had more indicators of poorly controlled asthma, including increased emergency health-care utilization, more daily rescue medication use, and lower use of ICSs, regardless of symptom control.
Authors: Michael Seid; Elizabeth J D'Amico; James W Varni; Jennifer K Munafo; Maria T Britto; Carolyn M Kercsmar; Dennis Drotar; Eileen C King; Lynn Darbie Journal: J Pediatr Psychol Date: 2011-12-13
Authors: J J Cutuli; Janette E Herbers; Theresa L Lafavor; Sandra M Ahumada; Ann S Masten; Charles N Oberg Journal: J Health Care Poor Underserved Date: 2014-05
Authors: Kathryn Blake; James D Cury; Jobayer Hossain; Kelan Tantisira; Jianwei Wang; Edward Mougey; John Lima Journal: Pulm Pharmacol Ther Date: 2013-02-04 Impact factor: 3.410