US racial/ethnic disparities in childhood asthma emergent health care use: National Health Interview Survey, 2013–2015

Abstract

Objective: Racial/ethnic disparities in Emergency Department (ED) visits due to childhood asthma are well documented. We assessed disparities among multiple racial/ethnic groups and examined the effects of asthma management in emergent health care use among children in the United States.

Methods: Data come from the sample child component of the 2013–2015 National Health Interview Survey (NHIS) (ages 2–17). Among children with current asthma, (N = 3336) we assessed racial/ethnic disparities in ED visits due to asthma in the past 12 months. We used multivariate logistic regression to calculate model adjusted odds ratios (ORs) including adjustment of asthma management questions available in NHIS 2013: use of an asthma action plan, preventative medication use, and an asthma management course.

Results: Using 2013–2015 NHIS data, Puerto Rican children had the highest prevalence of current asthma (21.2%). Among children with asthma, significantly higher odds of ED visits were seen among all minority subgroups (except non-Hispanic other) compared to non-Hispanic white children with Hispanic other having the highest adjusted odds ratio (OR = 2.4), followed by Puerto Rican (OR = 2.0), Mexican American (OR = 1.8) and non-Hispanic black children (OR = 1.7). In sub analyses using 2013 data, adjustment of management measures resulted in a modest to no effect in the odds of having an ED visit due to asthma.

Conclusions: The high prevalence of asthma and the disparity in asthma related ED visits among minority children exemplify the need for further research in understanding the mechanisms underlying the continuing existence of these health imbalances.

Keywords:

• National Health Interview Survey (NHIS)
• asthma management
• asthma action plan
• health disparities
• prevalence

Acknowledgements

We thank the Consulting for Statistics, Computing, and Analytics Research (CSCAR) center at the University of Michigan for statistical guidance. We also appreciate the invaluable critical review from anonymous reviewers.

Declaration of interest

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