05 Apr 2022
2 minutes reading
Source/Revelations
disclosures:
Kaufmann does not report any relevant financial disclosures. Pérez-Stable is director of the National Institute on Minority Health and Heath Disparities. See the study for the relevant financial disclosures from all other authors.
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A new study highlights different patterns of clinical use and ED acute care for asthma in non-Hispanic black and bilingual Latino children compared to non-Hispanic white children.
Non-Hispanic black children with asthma had lower use in the clinic but more use of the emergency room, and bilingual Latino children had higher use in the clinic for acute, chronic and preventive care, compared to non-Hispanic white children with asthma , researchers reported in Annals of Family Medicine.
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The observational study evaluated electronic health records of 41,276 children with asthma (mean age 7.6 years; 42.9% girls) from health centers in 18 US states. Researchers compared visits for clinic-coded asthma exacerbations from 2012 to 2018 in non-Hispanic black (n = 10,041), English-preferred Latino (n = 9,239), Hispanic-preferred Latino (n = 11,832) and non-Hispanic white children (n = 10,164) aged 3 to 17 years. In a subsample of 6,555 children insured under Oregon-Medicaid, researchers assessed asthma-related ED use and clinical admissions.
Non-Hispanic black children had the highest rate of moderate to severe asthma (10.6%) and fewer annual visits to health centers. Fifty-four percent had fewer than two annual visits.
Compared to non-Hispanic white children with asthma, preferred Hispanic children were more likely to have clinic visits for asthma exacerbations in the adjusted regression model (OR = 1.1; 95% CI, 1.02-1.18) and the Oregon-Medicaid subsample (OR = 1.36; 95% CI, 1.17-1.58).
Non-Hispanic Black children with asthma had a higher probability (OR = 1.4; 95% CI, 1.04-1.89) and higher annual rates (RR = 1.49; 95% CI, 1.09-2 ,04) of asthma-related ED use compared to non-Hispanic white children.
Researchers found no differences between racial and ethnic groups for asthma-related hospitalizations with an overall probability of less than 5% for all groups and an estimated rate of one to two admissions per 100 person-years.
“Our discovery suggests that the health center delivery model in some situations and groups may be more effective at reducing inequalities in some situations and groups than in others,” said Jorge Kaufmann, MD, MS, with the division of family medicine at Oregon Health and Science University, Portland, said in a related press release.
According to Kaufmann, further research could focus on features of community health center delivery approaches that could be improved or expanded to reach all populations in need of care.
“The findings of this study underscore the multifaceted nature of minority health and health disparities,” Eliseo J. Pérez-Stable, MD, director of the National Institute on Minority Health and Health Disparities, said in the release. “There are multiple social factors and levels of influence that can influence health behaviors within a population with the same diagnosis and these need to be explored to better understand and address health inequalities.”
Reference:
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