Disparities in emergency department visits in American children with asthma: 2006–2010

ABSTRACT

Objective: This article was to examine the trends in emergency department (ED) visits for asthma among American children in 2006–2010 across sociodemographic factors, parental smoking status, and children's body weight status. Methods: We analyzed 5,535 children aged 2–17 years with current asthma in the Asthma Call-Back Survey in 2006–2010. Multivariate log binomial regression was used to examine the disparities of ED visits by demographics, socioeconomic status, parental smoking status, children's body weight status, and the level of asthma control. We controlled for average state-level air pollutants. Prevalence ratios (PRs) and 95% confidence intervals (CIs) were reported. Results: Minority children with current asthma had higher risks of ED visits compared with white children in 2009 and 2010, e.g., the PR (95% CI) for black children in 2009 was 3.64 (1.79, 7.41). Children who had current asthma and more highly educated parents experienced a higher risk of ED visits in 2007 (PRs [95% CI] = 2.15 [1.02, 4.53] and 2.97 [1.29, 6.83] for children with some college or college-graduated parents), but not significant in other years. Children with uncontrolled asthma were significantly more likely to visit the ED in 2008 (PRs [95% CI] = 2.79 [1.44, 5.41] and 6.96 [3.55, 13.64] for not-well-controlled and very poorly controlled children with asthma). Conclusions: Minority children with current asthma or children with uncontrolled asthma were more likely to visit EDs for asthma treatment. However, the disparities in ED visits across sociodemographics, health status, or asthma control vary in scale and significance across time. More research is needed to explain these differences.

KEYWORDS:

• Asthma call back survey
• behavioral risk factor
• emergency care
• health disparities
• pediatric
• surveillance system

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Funding

This research was partially supported by the National Institutes of Health/National Heart Lung and Blood Institute (R21HL109973-01A1) and the National Institutes of Health/Eunice Kennedy Shriver National Institute of Child and Human Development (1R01HD064685-01A1).