ORIGINAL COMMUNICATION
Health Disparities in Pediatric Asthma: Comprehensive Tertiary Care Center Experience

https://doi.org/10.1016/S0027-9684(15)30045-6Get rights and content

Location

Study conducted at Nemours /Alfred I. duPont Hospital for Children, Wilmington, DE 19803

Background

Although the treatment and management of asthma hasimproved over time, incidence and prevalence among children continues to rise in the United States. Asthma prevalence, health services utilization, and mortality rate demonstrate remarkable disparities. The underlying causes of these disparities are not fully understood. We aimed to examine racial/ethnic variances in pediatric asthma prevalence/admission.

Patients and Methods

We retrospectively reviewed data on 1070 patients and applied a cross-sectional design to assess asthma admission between 2010 and 2011. Information was available on race/ethnicity, sex, insurance status, severity of illness (SOI), and length of stay/hospitalization (LOS).Chi-square statistic was used for the association between race and other variables in an attempt to explain the racial/ethnic variance.

Results

The proportionate morbidity of asthma was highest amongCaucasians (40.92%) and African Americans (40.54%), intermediate among others (16.57%), and lowest among Asian (0.56%), American Indian/Alaska Native (0.28%), and Hawaiian Native/Pacific Islander (0.28%). Overall there were disparities by sex, with more boys (61.80%) diagnosed with asthma than girls (38.20%), χ2(7) = 20.1, p = 0.005. Insurance status, and SOI varied by race/ethnicity, but not LOS. Caucasian children were more likely to have private insurance, while African Americans and Hispanics were more likely to have public insurance (p < 0.005). Asthma was more severe among non-Hispanic children, χ2(14) = 154.6, p < 0.001. While the overall readmission proportion was 2.8%, readmission significantly varied by race/ethnicity.

Conclusion

Racial/ethnic disparities in asthma admission exist among children in the Delaware Valley. There were racial/ethnic disparities in insurance status, asthma severity, and sex differed by race/ethnicity, but not in length of hospitalization.

REFERENCES (13)

  • D. Chandra et al.

    Race/ethnicity differences in the inpatient management of acute asthma in the United States

    Chest

    (2009)
  • Center for Disease Control and Prevention

    Asthma in the U.S. Vital Signs

    (May 2011)
  • S.Y. Liu et al.

    Hospital readmissions for childhood asthma: the role of individual and neighborhood factors

    Public Health Rep

    (2009)
  • L.J. Akinbami et al.

    Status of childhood asthma in the United States, 1980–2007

    Pediatrics.

    (2009)
  • C.L. Carroll et al.

    Childhood overweight increases hospital admission rates for asthma

    Pediatrics.

    (2007)
  • C.L. Bjornson et al.

    Gender differences in asthma in childhood and adolescence

    J Gend Specif Med.

    (2000)
There are more references available in the full text version of this article.

Cited by (0)

Financial Disclosure: All authors have declared no conflict of interest.

View full text