Inhaled corticosteroids in childhood asthma: Income differences in use

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Published on: April 6, 2017

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.

Pediatric Pulmonology
|August 12, 2003
PubMed

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.

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