Objective-To determine if parental literacy is related to emergency department visits, hospitalizations, and days of school missed for children with asthma.Methods-We performed a retrospective cohort study at a university pediatric clinic. We enrolled children between 3 and 12 years old with a diagnosis of asthma and a regular source of care at the site of the study and their parent or guardian. Primary asthma care measures included self-reported rates of emergency department visits, hospitalizations, and days of school missed. Secondary asthma care measures included rescue and controller medication use, classification of asthma severity and parental asthma-related knowledge.Results-We enrolled 150 children and their parents. Twenty-four percent of the parents had low literacy. Children of parents with low literacy had greater incidence of emergency department visits (adjusted incidence rate ratio [IRR] 1.5; 95% CI 1.1, 2.1), hospitalizations (IRR 3.2; 1.4, 7.3), and days missed from school (IRR 2.5; 2.1, 3.0) even after adjusting for asthma-related knowledge, disease severity, medication use and other socio-demographic factors. Parents with low literacy had less asthma-related knowledge, and their children were more likely to have moderate or severe persistent asthma and had greater use of rescue medications.Conclusions-Low parental literacy is associated with worse care measures for children with asthma.

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