Differences in Prevalence, Treatment, and Outcomes of Asthma Among a Diverse Population of Children With Equal Access to Care

Stewart, Kate; Higgins, Patricia; McLaughlin, Catherine G.; Williams, Thomas V.; Granger, Elder; Croghan, Thomas W.

doi:10.1001/archpediatrics.2010.100

Cited by 83 publications

(50 citation statements)

References 26 publications

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“…These findings are consistent with findings among children outside of foster care. Previous research has found that non-Hispanic black children are less likely to use controller medication than non-Hispanic white children (McDaniel & Waldfogel, 2012;Sarpong & Miller, 2013) and have more avoidable asthma hospitalizations and asthma-related emergency department visits (Stewart et al, 2010). However, these studies focused on children raised by parents in their homes, not in foster care by foster parents or shift personnel in congregate care.…”

Section: Discussionmentioning

confidence: 99%

“…The study sample was drawn from the population of Illinois children aged 5-17 years eligible for Medicaid due to child welfare system involvement or income between fiscal year (FY) 2010(July 1, 2009-June 30, 2012. We excluded children eligible for Medicaid due to disability although some of the children in foster care may have qualifying disabilities.…”

Section: Data and Study Samplementioning

confidence: 99%

See 1 more Smart Citation

Do children in foster care receive appropriate treatment for asthma?

Jaudes

Bilaver

Champagne

2015

Children and Youth Services Review

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Section: Discussionmentioning

confidence: 99%

Section: Data and Study Samplementioning

confidence: 99%

Do children in foster care receive appropriate treatment for asthma?

Jaudes

Bilaver

Champagne

2015

Children and Youth Services Review

View full text Add to dashboard Cite

“…A retrospective cohort analysis by Stewart et al, 43 in the military health system, assessed racial and ethnic differences in asthma prevalence, treatment patterns, and outcomes among a diverse population of children with equal access to healthcare. The theory behind the study was that the military health system provides comprehensive health insurance to a racially and ethnically diverse population, so studying disparities in healthcare treatment and outcomes in that population could substantially improve our understanding of possible effects of universal coverage on reducing disparities in healthcare.…”

Section: Sociocultural Factorsmentioning

confidence: 99%

Asthma: 2015 and Beyond

Myers

Tomasio

2011

Respir Care

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SummaryAsthma is a multifactorial, chronic inflammatory disease of the airways. The knowledge that asthma is an inflammatory disorder has become a core fundamental in the definition of asthma. Asthma's chief features include a variable degree of air-flow obstruction and bronchial hyper-responsiveness, in addition to the underlying chronic airways inflammation. This underlying chronic airway inflammation substantially contributes to airway hyper-responsiveness, air-flow limitation, respiratory symptoms, and disease chronicity. However, this underlying chronic airway inflammation has implications for the diagnosis, management, and potential prevention of the disease. This review for the respiratory therapy community summarizes these developments as well as providing an update on asthma epidemiology, natural history, cause, and pathogenesis. This paper also provides an overview on appropriate diagnostic and monitoring strategies for asthma, pharmacology, and newer therapies for the future as well as relevant management of acute and ambulatory asthma, and a brief review of educational approaches.

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“…1,2 Asthma is the most common chronic physical health condition of childhood, and morbidity disproportionately affects racial minorities. [3][4][5][6][7][8][9][10] Population-based studies that report racial disparities, however, rarely include patient-level details beyond traditional sociodemographic factors. 9 Further characterization of the challenges families face may help identify risks amenable to both clinical and public health interventions that could prevent subsequent morbidity and reduce disparities.…”

mentioning

confidence: 99%

Role of Financial and Social Hardships in Asthma Racial Disparities

Beck¹,

Huang

Simmons³

et al. 2014

Pediatrics

151

132

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BACKGROUND AND OBJECTIVES: Health care reform offers a new opportunity to address child health disparities. This study sought to characterize racial differences in pediatric asthma readmissions with a focus on the potential explanatory role of hardships that might be addressed in future patient care models. METHODS: We enrolled 774 children, aged 1 to 16 years, admitted for asthma or bronchodilator-responsive wheezing in a population-based prospective observational cohort. The outcome was time to readmission. Child race, socioeconomic status (measured by lower income and caregiver educational attainment), and hardship (caregivers looking for work, having no one to borrow money from, not owning a car or home, and being single/never married) were recorded. Analyses used Cox proportional hazards. RESULTS: The cohort was 57% African American, 33% white, and 10% multiracial/other; 19% were readmitted within 12 months. After adjustment for asthma severity classification, African Americans were twice as likely to be readmitted as whites (hazard ratio: 1.98; 95% confidence interval: 1.42 to 2.77). Compared with whites, African American caregivers were significantly more likely to report lower income and educational attainment, difficulty finding work, having no one to borrow money from, not owning a car or home, and being single/never married (all P ≤ .01). Hardships explained 41% of the observed racial disparity in readmission; jointly, socioeconomic status and hardship explained 49%. CONCLUSIONS: African American children were twice as likely to be readmitted as white children; hardships explained >40% of this disparity. Additional factors (eg, pollution, tobacco exposure, housing quality) may explain residual disparities. Targeted interventions could help achieve greater child health equity.

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Differences in Prevalence, Treatment, and Outcomes of Asthma Among a Diverse Population of Children With Equal Access to Care

Abstract: To assess racial and ethnic differences in asthma prevalence, treatment patterns, and outcomes among a diverse population of children with equal access to health care.

Cited by 83 publications

References 26 publications

Do children in foster care receive appropriate treatment for asthma?

Do children in foster care receive appropriate treatment for asthma?

Asthma: 2015 and Beyond

Role of Financial and Social Hardships in Asthma Racial Disparities

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