title: Health service deficits and school-aged children with asthma: a population-based study using data from the 2007-2008 National Survey of Child Health.
abstract: BACKGROUND
  Asthma is one of the most common and costly illnesses of childhood. This study addresses health services deficits experienced by school-aged children with asthma.
  
  
  METHODS
  Analyzing data from the 2007-2008 National Survey of Child Health, this cross-sectional study used household income, race/ethnicity, and geographic residency as the primary independent variables and health service deficits as the dependent variable.
  
  
  RESULTS
  Multivariate analysis yielded that other/multiracial (odds ratio [OR], 1.234; 95% confidence interval [CI], 1.226-1.242) and Hispanic (OR, 2.207; 95% CI, 1.226-1.242) school-aged children with asthma had greater odds of having health services deficits as did both urban (OR, 1.106; 95% CI, 1.099-1.113) and rural (OR, 1.133; 95% CI, 1.124-1.142) school-aged children with asthma. Children with either moderate (OR, 1.195; 95% CI, 1.184-1.207) or mild (OR, 1.445; 95% CI, 1.431-1.459) asthma had greater odds of having a health services deficit than those with severe asthma. Low-income school-aged children with asthma had greater odds of having a health services deficit than high-income children (OR, 1.031; 95% CI, 1.026-1.036). At lesser odds of having a health service deficit were those who were African American, of middle-range income, male, or who were school-aged children with asthma in good to excellent health.
  
  
  CONCLUSIONS
  Both African American and other/multiracial school-aged children were at greater risk of having asthma than either Caucasian or Hispanic children. Three vulnerable subgroups of school-aged children with asthma-rural, Hispanic, and those of low income were the most likely to have health service deficits.
authors.affiliation: Essentia Institute of Rural Health, Division of Research, 502 E Second St, Duluth, MN 55805, USA. mlutfiyya@eirh.org
authors.forename: M Nawal
authors.initials: MN
authors.lastname: Lutfiyya
authors.forename: Joel Emery
authors.initials: JE
authors.lastname: McCullough
authors.forename: Martin S
authors.initials: MS
authors.lastname: Lipsky
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000453:epidemiology* / Q000208:ethnology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005102:Health Expenditures; D006306:Health Surveys; D054625:Healthcare Disparities; D006801:Humans; D007182:Income; D008297:Male; D015999:Multivariate Analysis; D015995:Prevalence; D044469:Racial Groups / Q000706:statistics & numerical data*; D012111:Residence Characteristics; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States / Q000453:epidemiology