Disparities Found in Use of Pediatric Asthma Care
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Black children with asthma accessed community health centers (CHCs) less than White children, while Latino children (who prefer to speak either English or Spanish) were more likely to visit CHCs for acute, chronic and preventive care overall, according to a new, large NIMHD study published in Annals of Family Medicine.
The pattern of low clinic usage by Black children was accompanied by more frequent emergency department visits compared to the other groups. The difference in use at the CHC level suggests there are other factors beyond affordability influencing disparities in health care utilization.
Led by researchers at the Oregon Health & Science University, Portland, the study compared acute asthma care visits within CHCs, and the equivalent use within hospital emergency departments by race, ethnicity and language. The 7-year observational study conducted across 18 states using the electronic health records of 41,276 children with asthma found 54 percent of Black children had fewer than 2 visits annually, while for White and Spanish-preferring Latino children, it was 49.2 percent and 30.1 percent, respectively. The minimum standard of care for children with asthma is two visits annually.
Additionally, researchers examined how acute care use may reflect social factors across various domains, including aspects of poverty. Researchers found that most children in the study experienced a wealth gap, but Black children did so more often than others. These children may have been affected by greater financial instability, the inability of guardians to take work leave or fill prescriptions leading to lower primary care usage and increased exacerbations that could require emergency care.
Other research has shown that in equally segregated and socially deprived neighborhoods, immigrants have better health outcomes (including higher primary care usage) than non-immigrant Black people do. This contrast suggests the effects of long-term structural racism may have influenced the findings in this study.