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Asthma presents with a characteristic pattern of episodic respiratory symptoms that reflect underlying airway inflammation, bronchoconstriction, and mucus hypersecretion. Although severity varies among individuals, certain clinical manifestations are considered hallmarks of the disorder and often guide diagnosis and assessment.Respiratory SymptomsA persistent cough is one of the most common early features of asthma. It is frequently dry and tends to worsen at night or in the early morning,...
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Racial/ethnic differences in the presentation and management of severe bronchiolitis.

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Racial and ethnic disparities exist in severe bronchiolitis care. Non-Hispanic Black children received more albuterol pre-admission, while Hispanic children were more likely to be discharged on inhaled corticosteroids, deviating from guidelines.

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Area of Science:

  • Pediatric respiratory illnesses
  • Health services research
  • Health equity

Background:

  • Bronchiolitis is a leading cause of infant hospitalization in the US.
  • It is linked to an increased risk of childhood asthma.
  • Existing research shows racial/ethnic disparities in asthma care, but less is known about bronchiolitis.

Purpose of the Study:

  • To investigate racial and ethnic differences in the presentation and management of severe bronchiolitis.
  • To identify disparities in diagnostic imaging and treatment for hospitalized infants with bronchiolitis.

Main Methods:

  • A prospective cohort study involving 2130 infants <2 years old across 16 centers (2007-2010).
  • Data collected via structured interviews, chart reviews, and phone follow-up.
  • Multivariable logistic regression analyzed associations between race/ethnicity and care practices.

Main Results:

  • Non-Hispanic Black (NHB) children were more likely to receive albuterol before admission (OR: 1.58) and less likely to receive chest x-rays (OR: 0.66).
  • Hispanic children were more likely to be discharged on inhaled corticosteroids (OR: 1.92).
  • Observed disparities in pre-admission albuterol use, imaging, and discharge medications compared to non-Hispanic white (NHW) children.

Conclusions:

  • Significant racial/ethnic differences were found in severe bronchiolitis management.
  • These practices, including albuterol use, imaging, and inhaled corticosteroid prescriptions, deviate from American Academy of Pediatrics guidelines.
  • Further research into the causes of these disparities is needed, supporting the implementation of standardized care pathways.