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Disparities in emergency department visits in American children with asthma: 2006-2010
Qi Zhang1, Rajan Lamichhane2, Leigh Ann Diggs1
1a School of Community and Environmental Health, Old Dominion University , Norfolk , VA , USA.
Insights
Minority children with asthma and those with uncontrolled asthma had higher emergency department (ED) visit risks. Disparities in ED visits varied over time, requiring further research.
Area of Science:
- Pediatric Asthma Research
- Public Health Disparities
- Epidemiology of Childhood Asthma
Background:
- Emergency department (ED) visits for childhood asthma are a significant public health concern.
- Understanding trends and disparities in ED visits is crucial for targeted interventions.
- Sociodemographic factors, parental smoking, and body weight can influence asthma exacerbations.
Purpose of the Study:
- To examine trends in ED visits for asthma among US children from 2006-2010.
- To analyze disparities in ED visits based on sociodemographic factors, parental smoking, and children's body weight.
- To identify risk factors associated with increased ED utilization for pediatric asthma.
Main Methods:
- Analysis of 5,535 children aged 2-17 with current asthma from the 2006-2010 Asthma Call-Back Survey.
- Multivariate log binomial regression to assess disparities in ED visits.
- Controlled for average state-level air pollutants, demographics, socioeconomic status, parental smoking, body weight, and asthma control.
Main Results:
- Minority children with asthma showed higher ED visit risks in 2009 and 2010 compared to white children.
- Children with uncontrolled asthma had significantly higher odds of ED visits in 2008.
- Some associations between parental education and ED visits were observed in specific years.
Conclusions:
- Minority children and children with uncontrolled asthma face elevated risks of ED visits.
- Disparities in pediatric asthma ED visits vary in magnitude and statistical significance over time.
- Further research is necessary to elucidate the underlying reasons for these observed disparities.
Objective:
This article was to examine the trends in emergency department (ED) visits for asthma among American children in 2006-2010 across sociodemographic factors, parental smoking status, and children's body weight status.
Methods:
We analyzed 5,535 children aged 2-17 years with current asthma in the Asthma Call-Back Survey in 2006-2010. Multivariate log binomial regression was used to examine the disparities of ED visits by demographics, socioeconomic status, parental smoking status, children's body weight status, and the level of asthma control. We controlled for average state-level air pollutants. Prevalence ratios (PRs) and 95% confidence intervals (CIs) were reported.
Results:
Minority children with current asthma had higher risks of ED visits compared with white children in 2009 and 2010, e.g., the PR (95% CI) for black children in 2009 was 3.64 (1.79, 7.41). Children who had current asthma and more highly educated parents experienced a higher risk of ED visits in 2007 (PRs [95% CI] = 2.15 [1.02, 4.53] and 2.97 [1.29, 6.83] for children with some college or college-graduated parents), but not significant in other years. Children with uncontrolled asthma were significantly more likely to visit the ED in 2008 (PRs [95% CI] = 2.79 [1.44, 5.41] and 6.96 [3.55, 13.64] for not-well-controlled and very poorly controlled children with asthma).
Conclusions:
Minority children with current asthma or children with uncontrolled asthma were more likely to visit EDs for asthma treatment. However, the disparities in ED visits across sociodemographics, health status, or asthma control vary in scale and significance across time. More research is needed to explain these differences.
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