Racial and ethnic disparities in childhood asthma diagnosis: the role of clinical findings.
OBJECTIVE
To establish rates of childhood asthma symptoms, diagnosis, and hospitalization by race, ethnicity, and income, and to ascertain if elevated reported prevalence of asthma diagnosis among African-American children could be explained by differences in clinical findings.


METHODS
Estimates of each indicator were calculated based on data from the third National Health and Nutrition and Examination Survey (NHANES III). Bivariate and multivariate logistic regression models were estimated to predict parent or guardian report of current asthma diagnosis.


RESULTS
African-American children aged 1 to 5 have a 2-fold higher probability of both asthma diagnosis and hospitalization during the previous year but no significant difference in wheeze prevalence compared to Mexican-American and European-American children. These differences are not explained by household income or clinical information. Children aged 6 to 16 had similar rates of diagnosis and hospitalization for all racial/ethnic groups, although African-American children reported wheeze symptoms one-third less often.


CONCLUSIONS
Although younger African-American children have higher morbidity from asthma than their Mexican-American and European-American peers, clinical findings were similar and did not explain increased rates of diagnosis. Interpersonal dynamics within families and communication between families and clinicians are believed to influence both symptom reporting and diagnosis generation.
Roberts
Eric M
EM
Department of Pediatrics and Health Policy Studies, University of California at San Francisco, 94143, USA. erobert@itsa.ucsf.edu
D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data*; D017677:Age Distribution; D001249:Asthma / Q000175:diagnosis / Q000208:ethnology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007223:Infant; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data*; D012307:Risk Factors; D013223:Statistics as Topic; D044465:White People / Q000706:statistics & numerical data*