title: Ethnic and migrant differences in the use of anti-asthmatic medication for children: the effect of place of residence.
abstract: BACKGROUND
  Ethnic differences in the use of anti-asthmatic medication have been reported, with ethnic minorities being at a higher risk of suboptimal asthma control. As contextual socioeconomic characteristics may play a role, we analysed whether ethnic differences in the use of anti-asthmatic medication among children residing in the Capital Region of Denmark varied by place of residence.
  
  
  METHODS
  Data were obtained from the Danish Civil Registration System, the Central Taxpayers' Register and the Danish National Prescription Register and were linked at the individual level. Population used was the entire child population in the Capital Region from 0 to 17 years old in 2008 (n = 342,403). Use of anti-asthma medicine was defined as at least one prescription having been filled in 2008. The analyses included multiple multilevel logistic regression models.
  
  
  RESULTS
  Children living in low-income places of residence had lower odds of being prescribed preventive anti-asthmatics compared with children living in higher-income places of residence [odds ratio (OR) = 0.87, 95% confidence interval (CI) 0.84-0.91]. Immigrant children had the lowest OR of being prescribed anti-asthmatics medication, both relief (OR = 0.50, 95% CI 0.20-0.77) and preventive (OR = 0.47, 95% CI 0.24-0.82) compared with ethnic Danes. Similar associations were found among descendants of immigrant children (OR for preventive medication = 0.70, 95% CI 0.62-0.78). Place of residence contributed to but did not account for the ethnic differences in the use of anti-asthmatic medication.
  
  
  CONCLUSIONS
  Ethnic differences in the use of anti-asthmatic medication were documented, and they cannot be explained by socioeconomic characteristics of place of residence. The lower prevalence of anti-asthmatic medication among ethnic minority children suggests poor asthma management control.
authors.affiliation: Section for Social and Clinical Pharmacy, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Cantarero-Arévalo
authors.forename: Annette Kjaer
authors.initials: AK
authors.lastname: Ersbøll
authors.forename: Bjørn E
authors.initials: BE
authors.lastname: Holstein
authors.forename: Anette
authors.initials: A
authors.lastname: Andersen
authors.forename: Susanne
authors.initials: S
authors.lastname: Kaae
authors.forename: Ebba Holme
authors.initials: EH
authors.lastname: Hansen
mesh_terms: D000293:Adolescent; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003718:Denmark / Q000208:ethnology; D005006:Ethnicity / Q000208:ethnology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012042:Registries; D012111:Residence Characteristics; D014171:Transients and Migrants; D016896:Treatment Outcome
chemical_list: D018927:Anti-Asthmatic Agents
keywords: Denmark; asthma medication; children; minority group; multilevel analysis; pharmacoepidemiology