Poor Asthma Outcomes in Black Kids Despite Access to Care

MONDAY, June 7 (HealthDay News) -- Even with equal access to health care, black and Hispanic children are more likely than white children to have asthma and their outcomes are often worse, a U.S. study has found.

Researchers analyzed data from 822,900 children, aged 2 to 17, continuously enrolled throughout 2007 in TRICARE Prime, a Department of Defense health maintenance organization-type plan. Asthma prevalence, treatment and outcomes were assessed among children in three age groups: 2 to 4, 5 to 10, and 11 to 17.

The study found a number of racial and ethnic differences. Compared to whites, black and Hispanic children were more likely to be diagnosed with asthma at all ages, and black children of all ages and Hispanic children aged 5 to 10 were more likely to have potentially avoidable asthma-related hospitalizations or emergency department visits.

"Our findings with regard to treatment patterns were mixed," wrote Kate A. Stewart, of Mathematica Policy Research in Chicago, and colleagues. "Black children, who at all ages were more likely to have a diagnosis of asthma and to have poorer outcomes than white children, were also more likely to receive recommended asthma medications, especially inhaled corticosteroids."

But this finding could be linked to the higher rates of emergency department and hospital visits among black children. Medication prescriptions may have been written and filled during or after these visits, the study authors noted.

The researchers also found that black children were less likely to be treated by an asthma specialist, who would be more likely to follow treatment guidelines, including proper use of asthma control medications.

"Thus, even though black children filled more prescriptions for asthma medications, they may have been less likely than white children who visited specialists to control their asthma and use the medications properly," the researchers wrote.

"Our findings suggest that eliminating racial and ethnic disparities in health care likely requires a multifaceted approach beyond universal health insurance coverage," the authors concluded.

The study was released online June 7 in advance of publication in the August print issue of the journal Archives of Pediatrics & Adolescent Medicine.

-- Robert Preidt

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SOURCE: JAMA/Archives journals, news release, June 7, 2010