title: Trends in racial disparities for asthma outcomes among children 0 to 17 years, 2001-2010.
abstract: BACKGROUND
  Racial disparities in childhood asthma have been a long-standing target for intervention, especially disparities in hospitalization and mortality.
  
  
  OBJECTIVE
  Describe trends in racial disparities in asthma outcomes using both traditional population-based rates and at-risk rates (based on the estimated number of children with asthma) to account for prevalence differences between race groups.
  
  
  METHODS
  Estimates of asthma prevalence and outcomes (emergency department [ED] visits, hospitalizations, and deaths) were calculated from national data for 2001 to 2010 for black and white children. Trends were calculated using weighted loglinear regression, and changes in racial disparities over time were assessed using Joinpoint.
  
  
  RESULTS
  Disparities in asthma prevalence between black and white children increased from 2001 to 2010; at the end of this period, black children were twice as likely as white children to have asthma. Population-based rates showed that disparities in asthma outcomes remained stable (ED visits and hospitalizations) or increased (asthma attack prevalence, deaths). In contrast, analysis with at-risk rates, which account for differences in asthma prevalence, showed that disparities in asthma outcomes remained stable (deaths), decreased (ED visits, hospitalizations), or did not exist (asthma attack prevalence).
  
  
  CONCLUSIONS
  Using at-risk rates to assess racial disparities in asthma outcomes accounts for prevalence differences between black and white children, and adds another perspective to the population-based examination of asthma disparities. An at-risk rate analysis shows that among children with asthma, there is no disparity for asthma attack prevalence and that progress has been made in decreasing disparities in asthma ED visit and hospitalization rates.
authors.affiliation: Infant, Child and Women's Health Statistics Branch, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Md; US Public Health Service, Rockville, Md. Electronic address: lea8@cdc.gov.
authors.forename: Lara J
authors.initials: LJ
authors.lastname: Akinbami
authors.affiliation: Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Ga.
authors.forename: Jeanne E
authors.initials: JE
authors.lastname: Moorman
authors.affiliation: Infant, Child and Women's Health Statistics Branch, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Md.
authors.forename: Alan E
authors.initials: AE
authors.lastname: Simon
authors.affiliation: Infant, Child and Women's Health Statistics Branch, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Md; US Public Health Service, Rockville, Md.
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Schoendorf
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000453:epidemiology* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015995:Prevalence; D044469:Racial Groups; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States
keywords: Asthma; child; disparities; emergency room; epidemiology; hospitalization; mortality; prevalence; race
references.citation: J Pain Palliat Care Pharmacother. 2015 Jun;29(2):133-9
references.pmid: 26095483
references.citation: Biol Psychol. 2010 Apr;84(1):135-41
references.pmid: 19941934
references.citation: Am J Epidemiol. 2008 Apr 15;167(8):889-99
references.pmid: 18344513
references.citation: J Allergy Clin Immunol. 2014 Mar;133(3):654-61
references.pmid: 24581430
references.citation: J Allergy Clin Immunol. 2006 Feb;117(2):351-8
references.pmid: 16461136
references.citation: J Allergy Clin Immunol. 1998 May;101(5):594-601
references.pmid: 9600494
references.citation: Chest. 2005 Feb;127(2):571-8
references.pmid: 15705998
references.citation: Ambul Pediatr. 2001 Sep-Oct;1(5):275-9
references.pmid: 11888415
references.citation: Pediatrics. 1999 Jun;103(6):e75
references.pmid: 10353972
references.citation: Pediatrics. 2009 Mar;123 Suppl 3:S174-84
references.pmid: 19221161
references.citation: Pediatrics. 2012 Jan;129(1):62-9
references.pmid: 22144697
references.citation: J Asthma. 2003 Feb;40(1):27-39
references.pmid: 12699209
references.citation: Adv Data. 1995 Jul 6;(265):1-12
references.pmid: 10154340
references.citation: Biometrics. 2004 Dec;60(4):1005-14
references.pmid: 15606421
references.citation: Pediatrics. 2002 May;109(5):857-65
references.pmid: 11986447
references.citation: Natl Vital Stat Rep. 2013 May 8;61(4):1-117
references.pmid: 24979972
references.citation: Chest. 2000 May;117(5):1336-44
references.pmid: 10807820
references.citation: Chest. 2009 Oct;136(4):1063-1071
references.pmid: 19567492
references.citation: Pediatrics. 2009 Mar;123 Suppl 3:S131-45
references.pmid: 19221156
references.citation: Arch Pediatr Adolesc Med. 2002 Jun;156(6):562-7
references.pmid: 12038888
references.citation: J Health Care Poor Underserved. 2007 Feb;18(1):54-61
references.pmid: 17337797
references.citation: J Allergy Clin Immunol. 2006 Feb;117(2):233-40; quiz 241-2
references.pmid: 16461121
references.citation: Arch Pediatr Adolesc Med. 2000 Mar;154(3):287-93
references.pmid: 10710030
references.citation: Pediatrics. 2006 Jan;117(1):43-53
references.pmid: 16396859