Demographc Influences on Asthma Hospital Admission Rates in New York City

Palo, Vera A. De; Mayo, Paul H.; Friedman, Patricia; Rosen, Mark J.

doi:10.1378/chest.106.2.447

Cited by 68 publications

(28 citation statements)

References 13 publications

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“…Consistent with other literature in this area, 2,7,10,13,16,23 by guest on May 10, 2018 http://pediatrics.aappublications.org/ Downloaded from child's guardian to standard US Census categories. For the purpose of this analysis, mutually exclusive categories were determined: black (African-American, non-Hispanic), Hispanic, or white (non-Hispanic); patients designated as Asian or "other" ethnicity were excluded because of small numbers.…”

Section: Sociodemographics and Race/ethnicitysupporting

confidence: 83%

“…The evidence for this hypothesis is mixed. Although low SES independently and powerfully predicts poor asthma management and outcome, 4,5,7,13,16,23,24,28,36,37 only a few studies have shown that SES differences account for most or all of the race/ethnicity-based differences in asthma. 1,8,14,27,28 Many others have demonstrated that, even after controlling for factors such as income and insurance status, black and Hispanic children still have higher prevalence, 3,6,18,25 have more severe asthma symptoms, 12,19,22 visit the ED more often, 12,15,18 are hospitalized more frequently, 5,15,23 receive suboptimal preventive therapy, 4,11,15 and have greater mortality rates.…”

Section: Role Of Sesmentioning

confidence: 99%

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Race/Ethnicity and Asthma Among Children Presenting to the Emergency Department: Differences in Disease Severity and Management

et al. 2003

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ABSTRACT. Objective. To investigate racial/ethnic differences in acute asthma among children who present to the emergency department (ED).Method. We analyzed data from 2 prospective cohort studies performed during 1997-1998 as part of the Multicenter Airway Research Collaboration. Using a standardized protocol, researchers at 40 EDs in 18 US states provided 24-hour-per-day coverage for a median of 2 weeks per year. Children with acute asthma were interviewed in the ED and by telephone 2 weeks after discharge.Results. Among 1095 patients, 679 (62%) were black, 256 (23%) were Hispanic, and 160 (15%) were white. Black and Hispanic children had greater histories of lifetime (63%, 64%, 46%) and past-year (34%, 31%, 14%) hospitalization and more ED visits in the past year (medians: 2, 3, 1). Asthma severity at ED presentation, ED management and course, hospitalization during the index visit, discharge prescriptions, and postdischarge outcomes were equivalent among all race/ethnic groups.Conclusion. Despite pronounced race/ethnicity-based differences in chronic asthma, all racial/ethnic groups exhibited similar acute asthma severity, ED management, and course. However, given that black and Hispanic children exhibited much higher admission histories and past ED use, the equivalence in inhaled corticosteroid prescriptions on discharge is a disconcerting pattern that mirrors previous literature on outpatient prescription practices. In addition to barriers attributable to socioeconomic factors, health care providers and policy makers should target equalizing deficiencies in preventive medication prescription practices. Pediatrics 2003;111:e615-e621. URL: http://www.pediatrics.org/cgi/content/full/111/5/e615; asthma, children, socioeconomic status, race, ethnicity, quality of care.ABBREVIATIONS. ED, emergency department; MARC, Multicenter Airway Research Collaboration; PCP, primary care provider; SES, socioeconomic status. D espite effective therapies, asthma prevalence, morbidity, and mortality among children is increasing in the United States, and the burden is being borne disproportionately by blacks and Hispanics. Previous studies have focused primarily on racial/ethnic disparities noted in chronic care and management and have relied heavily on archival or billing data. To examine further the role of race/ ethnicity on asthma among children who present to the emergency department (ED), we examined prospective data from the Multicenter Airway Research Collaboration (MARC). On the basis of previous research, we hypothesized that black and Hispanic children with asthma would 1) exhibit more severe respiratory distress on arrival to the ED, 2) receive less adequate care while in the ED, 3) be admitted more often from the ED during their index visit, and 4) be more likely to relapse or have continued symptoms during the 2 weeks postdischarge. We further hypothesized that sociodemographic factors (including parental education, income, and insurance status) and access to a primary care provider (PCP) would play an important r...

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Section: Sociodemographics and Race/ethnicitysupporting

confidence: 83%

Section: Role Of Sesmentioning

confidence: 99%

Race/Ethnicity and Asthma Among Children Presenting to the Emergency Department: Differences in Disease Severity and Management

et al. 2003

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“…These poor outcomes are particularly common among African-American and inner-city patients for whom both hospitalizations and deaths related to asthma exacerbations are two to three times more likely than in other patient populations (64)(65)(66). These observations have led to a variety of inpatient programs to improve patients' self-management after hospital discharge (67,68).…”

Section: Table 4 Predictors Of Better Asthma Medication Knowledge Atmentioning

confidence: 99%

Tailored Education May Reduce Health Literacy Disparities in Asthma Self-Management

Paasche‐Orlow

Riekert

Bilderback

et al. 2005

Am J Respir Crit Care Med

239

202

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Health literacy is "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions" (1-4) and is most often measured by reading comprehension of health-related information (5, 6). Multiple studies indicate that inadequate health literacy is associated with worse health status and higher rates of hospitalization across a number of patient populations (4,7,8), including patients with diabetes mellitus, patients with HIV infection, and the elderly (9-12). However, there are relatively few data about the effects of inadequate health literacy in patients with asthma, a common chronic respiratory disorder affecting 5 to 10% of the U.S. population (13).

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“…1,2 Many clinical or area studies have reported substantially higher rates of asthma prevalence, [3][4][5] hospitalization, [6][7][8][9] and mortality among Black than White persons. 8,10,11 Because asthma is most common among low-socioeconomic status groups 12 and Black persons are more likely than White persons to be poor, 13 an important question is the extent to which racial/ethnic differences in asthma are due to poverty.…”

Section: Abstract Jane E Miller Phdmentioning

confidence: 99%

The effects of race/ethnicity and income on early childhood asthma prevalence and health care use

2000

Am J Public Health

171

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OBJECTIVES: Asthma is the most common chronic illness among US children and is most prevalent in low-income and minority groups. We used multivariate models to disentangle the effects of race/ethnicity, income, and other individual-level risk factors on asthma in a population-based sample of children aged 3 years. METHODS: Data are from the 1988 National Maternal and Infant Health Survey and 1991 Longitudinal Follow-Up. Odds ratios of asthma prevalence, hospitalization, and emergency room use were estimated, with control for socioeconomic characteristics, health behaviors, and insurance. RESULTS: Asthma prevalence, hospitalization, and emergency room use declined with increasing income for non-Black but not Black children. CONCLUSIONS: Lifetime income and sociodemographic characteristics do not explain the excess risks of asthma and emergency health care use for asthma among young Black children.

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Demographc Influences on Asthma Hospital Admission Rates in New York City

Cited by 68 publications

References 13 publications

Race/Ethnicity and Asthma Among Children Presenting to the Emergency Department: Differences in Disease Severity and Management

Race/Ethnicity and Asthma Among Children Presenting to the Emergency Department: Differences in Disease Severity and Management

Tailored Education May Reduce Health Literacy Disparities in Asthma Self-Management

The effects of race/ethnicity and income on early childhood asthma prevalence and health care use

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