Race may play a role in children's asthma care

Race may play a role in children's asthma care

University Park, Pa. -- Children in the United States suffer from asthma more than any other chronic illness, and new research finds African-American children with the condition have a greater risk than others of experiencing severe symptoms that escalate into an emergency.

Previous research has shown that in comparison with white and Hispanic children, African-Americans have a higher rate of asthma, are hospitalized more and face more disability due to the condition. Because of this, "we suspected they might also exhibit relatively more severe asthma symptoms at the time of hospitalization," said Yu Bai, a doctoral candidate in healthy policy and administration at Penn State.

The study appears in the February issue of the Journal of Health Care for the Poor and Underserved.

Penn State researchers Bai; Marianne Hillemeier, assistant professor of health policy and administration and demography, College of Health and Human Development; and E.J. Lengerich, associate professor of epidemiology, College of Medicine, analyzed the records of 7,726 white, African-American and Hispanic children up to age 19 who were admitted to Pennsylvania hospitals in 2001 for asthma symptoms. The researchers then examined how the physician reported the severity of the children's condition and ranked them either as "emergency" or "non-emergency" admissions.

Ninety percent of the African-American children had an emergency asthma condition compared with 60 percent of white and 64 percent of Hispanic children. In all, African-American children were more than twice as likely to have severe asthma symptoms as whites.

The Penn State researchers found that children on Medicaid had the most severe symptoms at admission compared with those who had private insurance -- and two-thirds of African-American children had Medicaid or other public insurance.

Other studies have shown that children on Medicaid have less access to primary care for asthma and are less likely to be prescribed the proper medication, according to the authors.

Bai said there's a need for improvement: "Providing greater resources to the Medicaid program would allow for more comprehensive provision of services that would help children and their families manage asthma, including case management services, provision of medically necessary equipment and supplies and referrals to asthma specialists when needed."

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Citation:
Bai Y, Hillemeier MM, Lengerich EJ. Racial/ethnic disparities in symptom severity among children hospitalized with asthma. Journal of Health Care for the Poor and Underserved 18(1), 2007.
www.press.jhu.edu/journals/journal_of_health_care_for_the_poor_and_underserved/

From Health News Behavior Service