title: Racial and ethnic disparities in asthma medication usage and health-care utilization: data from the National Asthma Survey.
abstract: BACKGROUND
  Despite the availability of effective treatment, minority children continue to experience disproportionate morbidity from asthma. Our objective was to identify and characterize racial and ethnic disparities in health-care utilization and medication usage among US children with asthma in a large multistate asthma survey.
  
  
  METHODS
  We analyzed questions from the 2003-2004 four-state sample of the National Asthma Survey to assess symptom control, medication use, and health-care utilization among white, black, and Hispanic children < 18 years old with current asthma who were residing in Alabama, California, Illinois, or Texas.
  
  
  RESULTS
  Of the 1,485 children surveyed, 55% were white, 25% were Hispanic, and 20% were black. Twice as many black children had asthma-related ED visits (39% vs 18%, respectively; p < 0.001) and hospitalizations (12% vs 5%, respectively; p = 0.02) compared with white children. Significantly fewer black and Hispanic children reported using inhaled corticosteroids (ICSs) in the past 3 months (21% and 22%, respectively) compared to white children (33%; p = 0.001). Additionally, 26% of black children and 19% of Hispanic children reported receiving a daily dose of a short-acting beta-agonist compared with 12% of white children (p = 0.001). ED visits were positively correlated with short-acting beta-agonist use and were negatively correlated with ICS use when stratified by race/ethnicity.
  
  
  CONCLUSIONS
  Children with asthma in this large, multistate survey showed a dramatic underuse of ICSs. Black and Hispanic children compared with white children had more indicators of poorly controlled asthma, including increased emergency health-care utilization, more daily rescue medication use, and lower use of ICSs, regardless of symptom control.
authors: Air Pollution and Respiratory Health Branch, Centers for Disease Control and Prevention, Atlanta GA. Electronic address: dvj4@cdc.gov.
authors: Deidre
authors: D
authors: Crocker
authors: Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta GA.
authors: Clive
authors: C
authors: Brown
authors: Division of Global Public Health Capacity Development, Centers for Disease Control and Prevention, Atlanta GA.
authors: Ronald
authors: R
authors: Moolenaar
authors: Air Pollution and Respiratory Health Branch, Centers for Disease Control and Prevention, Atlanta GA.
authors: Jeanne
authors: J
authors: Moorman
authors: Air Pollution and Respiratory Health Branch, Centers for Disease Control and Prevention, Atlanta GA.
authors: Cathy
authors: C
authors: Bailey
authors: Division of Pulmonary and Critical Care Medicine, University of Kentucky, Lexington KY.
authors: David
authors: D
authors: Mannino
authors: Department of Medicine, University of Pittsburgh, Pittsburgh, PA.
authors: Fernando
authors: F
authors: Holguin
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000407:Alabama; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000628:therapy*; D044383:Black People; D002140:California; D002648:Child; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005006:Ethnicity; D006296:Health Services / Q000706:statistics & numerical data*; D006306:Health Surveys; D006630:Hispanic or Latino; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007087:Illinois; D007407:Interviews as Topic; D044469:Racial Groups; D044465:White People; D001741:Black or African American
chemical_list: D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D018927:Anti-Asthmatic Agents