Related Experiment Video
Updated: Feb 5, 2026
Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
Published on: November 4, 2010
Racial Disparities in Asthma-Related Health Outcomes in Children with Severe/Difficult-to-Treat Asthma
Theresa Guilbert1, Robert S Zeiger2, Tmirah Haselkorn3
1Division of Pulmonology Medicine, Cincinnati Children's Hospital & Medical Center, Cincinnati, Ohio.
Insights
Asthma burden is higher in Black children compared to White children, with worse control and more severe outcomes. These disparities persist even after accounting for background and clinical factors.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Epidemiology
Background:
- Limited data exist on asthma etiology differences between Black and White children with severe or difficult-to-treat asthma.
- Understanding these disparities is crucial for targeted interventions.
Purpose of the Study:
- To compare demographic, clinical, and asthma-related outcomes between Black and White children.
- To investigate if confounding factors explain observed outcome differences.
Main Methods:
- Analysis of data from The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens study (n=348).
- Comparison of Black (n=86) and White (n=262) children aged 6-11 years.
- Sequential multivariable models were used to adjust for confounding factors.
Main Results:
- Black children were more likely to be male, obese, and from lower income strata.
- Black children exhibited higher IgE levels, poorer asthma control, increased corticosteroid use, lower quality of life, and more emergency department visits.
- These disparities in asthma control and exacerbation severity remained significant after adjusting for confounders.
Conclusions:
- Black children with severe or difficult-to-treat asthma experience a greater disease burden than White children.
- Disparities in clinical and patient-reported outcomes are not fully explained by background or clinical characteristics.
Background:
There are limited data that examine differences in asthma etiology between black and white children with severe or difficult-to-treat asthma.
Objective:
To describe demographic, clinical, and asthma-related outcomes in black and white children and examine whether differences in outcomes are explained by confounding factors in sequential multivariable models.
Methods:
Black (n = 86) and white (n = 262) children aged 6-11 years from The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens 3-year observational study were analyzed. Baseline demographics and clinical characteristics were described for both cohorts, and outcomes at month 12 were analyzed using statistical models, sequentially adjusting for potential confounders.
Results:
Black children were more likely to be male (79.1% vs 66.4%; P < .05), obese (12.8% vs 1.5%; P < .001), and from a lower income stratum (USD43,400 vs 55,770; P < .001) than white children. Black children had higher geometric mean IgE levels (434.8 vs 136.8 IU/mL; P < .001), were more likely to have very poorly controlled asthma (72.1% vs 53.4%), use long-term systemic corticosteroids (30.2% vs 9.2%; P < .001), have poorer quality of life (5.5 vs 6.1; P < .001), and have an emergency department visit (27.4% vs 7.7%, P < .001) in the 3 months before month 12. Differences in asthma control and the severity of exacerbations persisted even after accounting for all confounding factors.
Conclusions:
Among children with severe or difficult-to-treat asthma, asthma burden is greater in black than white children particularly related to several clinical and patient-reported outcome measures that are not explained by differences in background or clinical characteristics.
Related Concept Videos
01:29Asthma-I: Introduction
01:24Asthma-III: Symptoms and Complications
Classification of Asthma
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
01:26Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
01:30Asthma-IV: Nursing Management
First, in...