Asthma strikes Blacks, Latinos the most — and the worst
Asthma strikes African-American and Latino youth more often and much harder than it does young whites. According to a recent study, African-American and Latino youth of all ages have a higher incidence of asthma. African-American youth of all ages and Latino youth age 5-10 are more likely than whites to have avoidable hospitalizations or emergency room visits owing to asthma. What is most striking about these findings is that the study was conducted within a comprehensive health insurance system, which, supposedly, provides equal access to care to all its clients.
Many factors contribute to well-documented racial and ethnic disparities in children’s health and health care. Although lack of access to care — driven often by lack of health insurance — is a major source of such inequities, racial bias and discrimination within the health care system is also responsible for some of the disparities. “Because the Military Health System provides comprehensive health insurance to a racially and ethnically diverse population of beneficiaries, studying disparities in health care treatments and outcomes among this population could add significantly to our understanding of the potential effect of universal coverage on reducing disparities in health care,” these authors write.
The researchers analyzed data from 822,900 children age 2 through 17 who were continuously enrolled throughout 2007 in a Department of Defense health maintenance organization-type plan. Asthma prevalence, treatment patterns and outcomes were assessed among children age 2 to 4, 5 to 10 and 11 to 17.
“Our findings with regard to treatment patterns were mixed,” the authors write. “Black children, who at all ages were more likely to have a diagnosis of asthma and to have poorer outcomes than white children, were also more likely to receive recommended asthma medications, especially inhaled corticosteroids.” However, the authors note, increased visits to the emergency room could explain the higher use of corticosteroids in this population. Regular use of corticosteroids in an outpatient setting could help asthma sufferers avoid emergency room visits and hospitalizations for exacerbations of their illness. African-American youth in this study may not be receiving appropriate asthma medication outside the hospital.
“Our findings suggest that eliminating racial and ethnic disparities in health care likely requires a multifaceted approach beyond universal health insurance coverage,” they conclude.