Related Experiment Videos
Inhaled corticosteroids in childhood asthma: Income differences in use
Anita L Kozyrskyj1, Cameron A Mustard, F Estelle R Simons
1Department of Community Health Sciences, Manitoba Centre for Health Policy, Faculty of Pharmacy, University of Manitoba, Winnipeg, Manitoba, Canada.
Insights
Children with lower household incomes are less likely to receive inhaled corticosteroid prescriptions for asthma, even with universal healthcare access. This disparity highlights a socioeconomic gradient in essential asthma medication use.
Area of Science:
- Pediatric Pulmonology
- Health Services Research
- Social Determinants of Health
Background:
- Asthma hospitalization rates in children are inversely associated with household income.
- Inhaled corticosteroids (ICS) are crucial for preventing asthma exacerbations and hospitalizations.
- Understanding medication access disparities is vital for equitable pediatric asthma care.
Purpose of the Study:
- To investigate the association between socioeconomic status and the utilization of inhaled corticosteroid prescriptions among children with asthma.
- To determine if a socioeconomic gradient exists in ICS use, mirroring the gradient observed in hospitalization rates.
Main Methods:
- Cross-sectional study utilizing population-based prescription and healthcare data.
- Inclusion of 16,862 children aged 5-15 years with asthma drug prescriptions in Manitoba (January 1995-March 1996).
- Analysis adjusted for asthma severity, physician specialty, and neighborhood income.
Main Results:
- Overall, 45% of children treated for asthma received at least one ICS prescription.
- A significant decrease in the proportion of ICS prescriptions was observed with declining neighborhood income levels.
- The socioeconomic gradient in ICS use was most pronounced in children with mild-moderate asthma not managed by asthma specialists.
Conclusions:
- A socioeconomic gradient in inhaled corticosteroid prescription use exists among children with asthma, even within a universal healthcare system.
- This disparity suggests potential barriers to optimal asthma management related to income.
- Further research is needed to address these inequities in pediatric asthma care.
Abstract:
Asthma hospitalization rates in children increase with decreasing level of household income. This research was undertaken to determine whether use of inhaled corticosteroid drugs, which can prevent asthma hospitalizations, followed a similar socioeconomic gradient in children with asthma. We performed a cross-sectional study of association, using population-based prescription and healthcare data sources. Our subjects were 16,862 Manitoba children, aged 5-15 years, with prescriptions for asthma drugs during January 1995-March 1996. Our measures were adjusted for asthma severity, physician specialty, and proportion of children with an inhaled corticosteroid prescription by neighborhood income. Forty-five percent of children treated for asthma had at least one inhaled corticosteroid prescription during January 1995-March 1996. The proportion of children with inhaled corticosteroid prescriptions decreased with successive decreases in neighborhood income. The socioeconomic gradient in the likelihood of an inhaled corticosteroid prescription was most evident among children with mild-moderate asthma who were not in the care of an asthma specialist. In conclusion, a socioeconomic gradient in the use of inhaled corticosteroids prescriptions can be found among children with universal access to healthcare and drug insurance.