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Trends in US Pediatric Asthma Hospitalizations, by Race and Ethnicity, 2012-2020
Sophie Binney1,2, W Dana Flanders3, Kanta Sircar4,5
1Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee.
Insights
Pediatric asthma hospitalizations are decreasing across all racial groups, but disparities persist. Non-Hispanic Black children still experience the highest asthma burden, indicating a need for targeted interventions.
Area of Science:
- Public Health
- Epidemiology
- Health Disparities
Background:
- Racial and ethnic minority communities disproportionately experience higher asthma burdens.
- Previous studies indicated stable or increasing pediatric asthma disparities.
- Updated data analysis is crucial for understanding current trends in pediatric asthma disparities.
Purpose of the Study:
- To analyze recent trends in pediatric asthma hospitalization disparities by race and ethnicity.
- To assess changes in asthma hospitalization rates among different racial and ethnic groups from 2012 to 2020.
- To determine if existing racial and ethnic disparities in pediatric asthma have changed over time.
Main Methods:
- Utilized National Inpatient Sample data from 2012-2020 for pediatric asthma hospitalizations.
- Calculated hospitalization rates using US Census Bureau data and performed meta-regression analysis.
- Accounted for a 2015 diagnostic coding change by conducting separate analyses for pre- and post-change periods, excluding 2020 data from regression.
Main Results:
- Pediatric asthma hospitalizations decreased overall during the study period.
- Non-Hispanic Black children exhibited the highest prevalence of asthma hospitalizations (9.8-36.7 per 10,000 children).
- Rates of decrease in asthma hospitalizations were similar across all racial and ethnic groups, suggesting persistent disparities.
Conclusions:
- Non-Hispanic Black children continue to face a disproportionate burden of asthma-related hospitalizations.
- While asthma hospitalization prevalence is declining universally, the similar rates of decline across groups indicate that disparities persist.
- Targeted interventions addressing the specific needs of disproportionately affected groups are essential to reduce pediatric asthma disparities.
Introduction:
Some racial and ethnic minority communities have long faced a higher asthma burden than non-Hispanic White communities. Prior research on racial and ethnic pediatric asthma disparities found stable or increasing disparities, but more recent data allow for updated analysis of these trends.
Methods:
Using 2012-2020 National Inpatient Sample data, we estimated the number of pediatric asthma hospitalizations by sex, age, and race and ethnicity. We converted these estimates into rates using data from the US Census Bureau and then conducted meta-regression to assess changes over time. Because the analysis spanned a 2015 change in diagnostic coding, we performed separate analyses for periods before and after the change. We also excluded 2020 data from the regression analysis.
Results:
The number of pediatric asthma hospitalizations decreased over the analysis period. Non-Hispanic Black children had the highest prevalence (range, 9.8-36.7 hospitalizations per 10,000 children), whereas prevalence was lowest among non-Hispanic White children (range, 2.2-9.4 hospitalizations per 10,000 children). Although some evidence suggests that race-specific trends varied modestly across groups, results overall were consistent with a similar rate of decrease across all groups (2012-2015, slope = -0.83 [95% CI, -1.14 to -0.52]; 2016-2019, slope = -0.35 [95% CI, -0.58 to -0.12]).
Conclusion:
Non-Hispanic Black children remain disproportionately burdened by asthma-related hospitalizations. Although the prevalence of asthma hospitalization is decreasing among all racial and ethnic groups, the rates of decline are similar across groups. Therefore, previously identified disparities persist. Interventions that consider the specific needs of members of disproportionately affected groups may reduce these disparities.
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