Racial and Ethnic Disparities in Current Asthma and Emergency Department Visits: Findings from the National Health Interview Survey, 2001–2010

Abstract

Objectives-Racial/ethnic disparities in current asthma prevalence and medical care are a major public health concern. We examined the differences in asthma prevalence and morbidity among major racial/ethnic populations in the U.S.Methods-We analyzed data from the 2001-2010 National Health Interview Survey for adults (≥18 years) and children and adolescents (<18 years). Outcome variables were current asthma prevalence, episodes and emergency department/urgent care center (ED/UCC) visits. We used multivariate logistic regression to calculate model-adjusted prevalence and risk ratios (ARR).Results-In our study, 9.0% children and 7.2% adults had current asthma. Non-Hispanic black and Puerto Rican children were more likely to have current asthma (ARR 1.46, 1.66 respectively) and ED/UCC visits (ARR 1.61, 1.66, respectively) than non-Hispanic whites. Prevalence of asthma episodes did not differ significantly (P>0.05) among different race/ethnicities after adjusting for covariates. Among adults, Puerto Ricans were more likely to have current asthma (ARR 1.60) than non-Hispanic whites, and Non-Hispanic blacks (ARR 1.78) and Puerto Rican adults (ARR 1.71) reported ED/UCC visits more frequently than non-Hispanic whites. Adults and children who received emergency care for asthma in the past 12 months more frequently received multiple components of asthma management and control (e.g., taking long-term medication, having an asthma management plan) compared to those without emergency care.Conclusions-Racial/ethnic differences in current asthma prevalence persist among children and adults, but are most prominent among adults with asthma-related ED/UCC visits. Appropriate

Asthma coalition effects on vulnerable sub groups of children: the most frequent users of health care and the youngest

“…By age, there were more males in the 2-3-year-old group and also more significant asthma events in this group. These findings are consistent with those reported in previous studies [8][9][10].…”

“…Frequent urgent health care utilization and younger age have been shown to be associated with more disease burden for children with asthma, their families and the health care system [3][4][5][6][7]. High rates of urgent care use for asthma are associated with residing in low income and minority communities [8][9][10]. A variety of ways have been examined in which to improve services, provide selfmanagement support to patients and reduce the demand for more expensive asthma care [11][12].…”

The Impact of Parent's Health Literacy on Pediatric Asthma Outcomes

“…This may, in part, explain why African American children suffer disproportionate asthma morbidity and mortality, as well healthcare use. 8,49 The child's asthma control relies on the parent's ability for symptom management at home, which includes medication use, symptom monitoring, and following an asthma action plan. The parent needs to be able to read the asthma action plan, understand how to monitor symptoms, and use medication such as a metered-dose inhaler properly.…”

Racial and Ethnic Disparities in the Quality of Health Care

“…Minority populations often fare worse for these outcomes, meaning that they are hospitalized and rehospitalized more often. Specifically, African Americans have higher rates of all-cause rehospitalization (80) and higher hospitalization and rehospitalization for potentially avoidable causes, e.g., asthma (4,84,109), diabetes (77,94), heart failure (28), and postsurgery complications (142).…”