Reasons for racial differences in A & E attendance rates for asthma.

To determine whether racial differences in the severity of asthma accounted for the higher accident and emergency department (A & E) use by Pacific Islanders and Maoris, a study of A & E users at Middlemore Hospital and of asthmatics using urgent medical services was undertaken. Europeans reported more daytime symptoms of asthma (p less than 0.0005) and were on more medications (p less than 0.005) than Pacific Islanders, with Maoris intermediate (ns). Relative to the perceived severity of their asthma, both Maoris and Pacific Islanders lost more time from work or school and used hospital services more than European asthmatics using A & E. The increased use of A & E by Maori and Pacific Island asthmatics seemed not attributable to the intrinsic severity of their asthma and was better explained by ethnic, socioeconomic and sociocultural factors. Pacific Islanders had less self management skills and, like Maoris, were less likely to be on prophylactic medications relative to oral bronchodilator use and these factors likely contributed to their increased morbidity.