title: Are minority children the last to benefit from a new technology? Technology diffusion and inhaled corticosteriods for asthma.
abstract: BACKGROUND
  Racial and ethnic disparities in health and health care have been well documented, but few studies have addressed how disparities may change over time.
  
  
  OBJECTIVE
  We sought to determine the change in relative rates over time of corticosteroid metered dose inhaler (MDI) use in minority and nonminority populations with asthma.
  
  
  METHODS
  We used a cross-sectional survey for 5 periods of 2 years' each (1989-1990, 1991-1992, 1993-1994, 1995-1996, 1997-1998) using the National Ambulatory Medical Care Surveys (NAMCS).
  
  
  METHODS
  A total of 3671 visits by adults and children with asthma to U.S. office-based physicians comprised our sample.
  
  
  METHODS
  We sought to measure differences in inhaled corticosteroid use for minority and nonminority adults and children controlling for gender, specialty, U.S. region, and type of insurance.
  
  
  RESULTS
  Minority patients with asthma were less than half as likely as nonminority patients to have had a steroid MDI prescribed during 1989-1990. By 1995-1996, minority and nonminority patients with asthma were equally likely to have had a steroid MDI prescribed. Although differences between black and white patients resolved, differences between white and Hispanic patients persisted even after adjusting for insurance. Children initially were less likely than adults with asthma to have steroid MDI prescribed, and this difference persisted. Minority children had the greatest delay in adoption of steroid MDIs.
  
  
  CONCLUSIONS
  Steroid MDIs diffused into minority and nonminority adult and child populations at different rates.
authors.affiliation: Institute for Health Policy, Massachusetts General Hospital, Partners HealthCare System, and Harvard Medical School, Boston, Massachusetts 02114, USA. tferris@partners.org
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Ferris
authors.forename: Karen
authors.initials: K
authors.lastname: Kuhlthau
authors.forename: John
authors.initials: J
authors.lastname: Ausiello
authors.forename: James
authors.initials: J
authors.lastname: Perrin
authors.forename: Robert
authors.initials: R
authors.lastname: Kahn
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D001741:Black or African American; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003625:Data Collection; D004059:Diffusion of Innovation; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D036501:Metered Dose Inhalers / Q000706:statistics & numerical data*; D008875:Middle Aged; D008913:Minority Groups; D014481:United States; D044465:White People
chemical_list: D000305:Adrenal Cortex Hormones