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Racial and ethnic differences in asthma diagnosis among children who wheeze.
Pediatrics 2005; 115(5):1254-60Ped

Abstract

BACKGROUND

Racial and ethnic disparities exist in reported childhood asthma prevalence, but it is unclear if disparities stem from true prevalence differences or a different likelihood of receiving a diagnosis from a health professional. Concern has been raised that asthma may be underdiagnosed, particularly among minority children who have more restricted access to high-quality health care.

OBJECTIVE

To examine racial/ethnic differences among currently symptomatic children in acquiring an asthma diagnosis to determine if relative underdiagnosis among minorities exists. Children for whom no symptoms were reported (a group that includes those with well-controlled symptoms) were excluded from the analysis.

METHODS

The 1999 National Health Interview Survey includes a nationally representative sample of children with reported wheezing symptoms. We included children 3 to 17 years old in the study and analyzed racial/ethnic differences in asthma diagnosis, controlling for young age, gender, parental education, single-parent household, central-city residence, region of residence, health insurance, having a usual place of care, and parent-reported severity of wheezing symptoms.

RESULTS

Among those reported to have wheezed in the past year (n = 946), 83% of Puerto Rican, 71% of non-Hispanic black, and 65% of Mexican children were diagnosed with asthma compared with 57% of non-Hispanic white children. Using non-Hispanic white children as the reference group, the approximate adjusted relative risk for physician diagnosis of asthma given wheezing in the past year was 1.43 (95% confidence interval [CI]: 1.04, 1.63) for Puerto Rican, 1.22 (95% CI: 1.03, 1.37) for non-Hispanic black, and 1.19 (95% CI: 0.94, 1.39) for Mexican children. Minority children were reported to have greater severity of wheezing symptoms. Even after accounting for this increased severity, children in racial and ethnic minority groups were as or more likely to have a reported asthma diagnosis than non-Hispanic white children.

CONCLUSIONS

Our findings do not provide evidence for the hypothesis that symptomatic minority children are underdiagnosed with asthma compared with non-Hispanic white children. To the contrary, among currently symptomatic children, minority children were more likely to be diagnosed than non-Hispanic white children even after accounting for the higher wheezing severity among minority children.

Authors+Show Affiliations

Infant, Child, and Women's Health Studies Branch, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland 20782, USA. lea8@cdc.govNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15867032

Citation

Akinbami, Lara J., et al. "Racial and Ethnic Differences in Asthma Diagnosis Among Children Who Wheeze." Pediatrics, vol. 115, no. 5, 2005, pp. 1254-60.
Akinbami LJ, Rhodes JC, Lara M. Racial and ethnic differences in asthma diagnosis among children who wheeze. Pediatrics. 2005;115(5):1254-60.
Akinbami, L. J., Rhodes, J. C., & Lara, M. (2005). Racial and ethnic differences in asthma diagnosis among children who wheeze. Pediatrics, 115(5), pp. 1254-60.
Akinbami LJ, Rhodes JC, Lara M. Racial and Ethnic Differences in Asthma Diagnosis Among Children Who Wheeze. Pediatrics. 2005;115(5):1254-60. PubMed PMID: 15867032.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Racial and ethnic differences in asthma diagnosis among children who wheeze. AU - Akinbami,Lara J, AU - Rhodes,Julia C, AU - Lara,Marielena, PY - 2005/5/4/pubmed PY - 2005/9/28/medline PY - 2005/5/4/entrez SP - 1254 EP - 60 JF - Pediatrics JO - Pediatrics VL - 115 IS - 5 N2 - BACKGROUND: Racial and ethnic disparities exist in reported childhood asthma prevalence, but it is unclear if disparities stem from true prevalence differences or a different likelihood of receiving a diagnosis from a health professional. Concern has been raised that asthma may be underdiagnosed, particularly among minority children who have more restricted access to high-quality health care. OBJECTIVE: To examine racial/ethnic differences among currently symptomatic children in acquiring an asthma diagnosis to determine if relative underdiagnosis among minorities exists. Children for whom no symptoms were reported (a group that includes those with well-controlled symptoms) were excluded from the analysis. METHODS: The 1999 National Health Interview Survey includes a nationally representative sample of children with reported wheezing symptoms. We included children 3 to 17 years old in the study and analyzed racial/ethnic differences in asthma diagnosis, controlling for young age, gender, parental education, single-parent household, central-city residence, region of residence, health insurance, having a usual place of care, and parent-reported severity of wheezing symptoms. RESULTS: Among those reported to have wheezed in the past year (n = 946), 83% of Puerto Rican, 71% of non-Hispanic black, and 65% of Mexican children were diagnosed with asthma compared with 57% of non-Hispanic white children. Using non-Hispanic white children as the reference group, the approximate adjusted relative risk for physician diagnosis of asthma given wheezing in the past year was 1.43 (95% confidence interval [CI]: 1.04, 1.63) for Puerto Rican, 1.22 (95% CI: 1.03, 1.37) for non-Hispanic black, and 1.19 (95% CI: 0.94, 1.39) for Mexican children. Minority children were reported to have greater severity of wheezing symptoms. Even after accounting for this increased severity, children in racial and ethnic minority groups were as or more likely to have a reported asthma diagnosis than non-Hispanic white children. CONCLUSIONS: Our findings do not provide evidence for the hypothesis that symptomatic minority children are underdiagnosed with asthma compared with non-Hispanic white children. To the contrary, among currently symptomatic children, minority children were more likely to be diagnosed than non-Hispanic white children even after accounting for the higher wheezing severity among minority children. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/15867032/Racial_and_ethnic_differences_in_asthma_diagnosis_among_children_who_wheeze_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=15867032 DB - PRIME DP - Unbound Medicine ER -