Racial disparities at the point of care for urban children with persistent asthma

J Community Health. 2014 Aug;39(4):706-11. doi: 10.1007/s10900-013-9815-5.

Abstract

Little is known about disparities in preventive asthma care delivery at the time of an office visit. Our objective was to better understand what treatments are delivered at the point of care for urban children with asthma, and whether there are racial disparities. We enrolled 100 Black and 77 White children (2-12 years) with persistent asthma from 6 primary care practices. We evaluated how frequently providers delivered guideline-based asthma actions at the index visit. We also assessed asthma morbidity prior to the index visit and again at 2 month follow-up. Black children had greater symptom severity and were less likely to report having a preventive medication at baseline, but were no more likely to report a preventive medication action at the time of an office visit. Symptoms persisted for Black children at follow-up, suggesting additional preventive actions were needed. Further efforts to promote consistent guideline-based preventive asthma care are critical.

Trial registration: ClinicalTrials.gov NCT01105754.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Anti-Asthmatic Agents / administration & dosage
  • Anti-Asthmatic Agents / adverse effects
  • Anti-Asthmatic Agents / therapeutic use
  • Asthma / drug therapy
  • Asthma / ethnology*
  • Asthma / prevention & control
  • Black or African American / statistics & numerical data*
  • Caregivers / statistics & numerical data
  • Child
  • Child, Preschool
  • Disease Progression
  • Female
  • Guideline Adherence / statistics & numerical data
  • Healthcare Disparities / ethnology*
  • Humans
  • Logistic Models
  • Male
  • New York
  • Office Visits / statistics & numerical data
  • Practice Guidelines as Topic
  • Primary Health Care / standards*
  • Primary Health Care / statistics & numerical data
  • Severity of Illness Index
  • Tobacco Smoke Pollution / adverse effects
  • Tobacco Smoke Pollution / statistics & numerical data*
  • Urban Health / statistics & numerical data
  • White People / statistics & numerical data*

Substances

  • Anti-Asthmatic Agents
  • Tobacco Smoke Pollution

Associated data

  • ClinicalTrials.gov/NCT01105754