Patrick W Sullivan1, Vahram Ghushchyan2, Abhishek Kavati3, Prakash Navaratnam4, Howard S Friedman4, Benjamin Ortiz3. 1. Regis University School of Pharmacy, Denver, Colo. Electronic address: psulliva@regis.edu. 2. University of Colorado, Denver, Colo; American University of Armenia, Yerevan, Armenia. 3. Novartis Pharmaceuticals Corporation, East Hanover, NJ. 4. DataMed Solutions LLC, New York, NY.
Abstract
BACKGROUND: Children residing in poor-urban areas may have greater asthma morbidity. It is unclear whether this is due to individual characteristics such as race and ethnicity or place of residence. OBJECTIVE: Assess indicators of control and treatment by residence. METHODS: This was a cross-sectional analysis of children (aged 1-17 years) in the 2000-2014 Medical Expenditure Panel Survey (MEPS). Indicators of poor control included use of more than 3 canisters of short-acting beta agonist (SABA) in 3 months, asthma attack, and emergency department (ED) or inpatient (IP) visit during the year. Treatment measures included use of controller medications and a ratio of controller-to-total prescriptions of 0.7 or more. RESULTS: There were 15,052 children with asthma in the MEPS 2000-2014 data, reflecting 8.4 million children in 2014. After controlling for covariates, children with asthma residing in poor-urban areas had lower odds of using controller medications (odds ratio [OR] = 0.77), having a controller-to-total ratio of 0.7 or more (OR = 0.75), and reporting an asthma attack (OR = 0.75) and higher odds of having an ED/IP visit (OR = 1.3) compared with those living elsewhere. Black race and Hispanic ethnicity were associated with greater odds of excessive SABA use (OR = 2.11) and ED/IP visits (OR = 2.03) and lower odds of controller-to-total ratio of 0.07 or more (OR = 0.50). CONCLUSIONS: Poor-urban residence may be independently associated with asthma control and treatment even after controlling for individual characteristics such as race and ethnicity. Future research is needed to understand the sources of these geographic health disparities to more successfully target public health interventions.
BACKGROUND:Children residing in poor-urban areas may have greater asthma morbidity. It is unclear whether this is due to individual characteristics such as race and ethnicity or place of residence. OBJECTIVE: Assess indicators of control and treatment by residence. METHODS: This was a cross-sectional analysis of children (aged 1-17 years) in the 2000-2014 Medical Expenditure Panel Survey (MEPS). Indicators of poor control included use of more than 3 canisters of short-acting beta agonist (SABA) in 3 months, asthma attack, and emergency department (ED) or inpatient (IP) visit during the year. Treatment measures included use of controller medications and a ratio of controller-to-total prescriptions of 0.7 or more. RESULTS: There were 15,052 children with asthma in the MEPS 2000-2014 data, reflecting 8.4 million children in 2014. After controlling for covariates, children with asthma residing in poor-urban areas had lower odds of using controller medications (odds ratio [OR] = 0.77), having a controller-to-total ratio of 0.7 or more (OR = 0.75), and reporting an asthma attack (OR = 0.75) and higher odds of having an ED/IP visit (OR = 1.3) compared with those living elsewhere. Black race and Hispanic ethnicity were associated with greater odds of excessive SABA use (OR = 2.11) and ED/IP visits (OR = 2.03) and lower odds of controller-to-total ratio of 0.07 or more (OR = 0.50). CONCLUSIONS: Poor-urban residence may be independently associated with asthma control and treatment even after controlling for individual characteristics such as race and ethnicity. Future research is needed to understand the sources of these geographic health disparities to more successfully target public health interventions.
Authors: Patrick H Ryan; Cole Brokamp; Jeff Blossom; Nathan Lothrop; Rachel L Miller; Paloma I Beamer; Cynthia M Visness; Antonella Zanobetti; Howard Andrews; Leonard B Bacharier; Tina Hartert; Christine C Johnson; Dennis Ownby; Robert F Lemanske; Heike Gibson; Weeberb Requia; Brent Coull; Edward M Zoratti; Anne L Wright; Fernando D Martinez; Christine M Seroogy; James E Gern; Diane R Gold Journal: J Clin Transl Sci Date: 2021-02-05
Authors: Jean Hunleth; Julie Spray; Sienna Ruiz; Julia Maki; David A Fedele; Sreekala Prabhakaran; Rachel B Forsyth; Cassidy Sykes; Kaylah Crepps; James Shepperd; Deb Bowen; Erika A Waters Journal: J Asthma Date: 2020-10-27 Impact factor: 2.515