title: Influences of asthma on reported health indicators and access to health care among children.
abstract: BACKGROUND
  Studies on the influences of pediatric asthma on health and access to health care were conducted in limited geographic areas or age groups.
  
  
  OBJECTIVE
  To investigate associations of asthma with health, use of medical care, mental health or educational services, activity limitations, problems in paying bills, and frustrations in obtaining health care among children in the United States. Caregivers reported children's conditions.
  
  
  METHODS
  Logistic regression models were adjusted for sociodemographic factors in the nationally representative 2011/2012 National Survey of Children's Health.
  
  
  RESULTS
  Of the 91,116 children 0 to 17 years old, 14.6% had reported asthma. Of children 0 to 17 years old with asthma, 21.2% were non-Hispanic black. Of children 0 to 17 years old without asthma, 12.2% were non-Hispanic black. In children 0 to 17 years old, compared with children without asthma, children with asthma had an increased odds to have reported fair or poor health, receive more medical care, mental health, and educational services than usual, have activity limitations, have medical bills that the family had problems paying (odds ratio 1.5, 95% confidence interval 1.3-1.7), and have caregivers who were frustrated in obtaining care (odds ratio 1.5, 95% confidence interval 1.2-1.7). The odds ratios for the associations between asthma and all outcomes were higher in the 0- to 5-year-old compared with the 6- to 17-year-old group.
  
  
  CONCLUSIONS
  When adjusting for sociodemographic variables, caregivers have problems paying bills and obtaining health care services for their child. To develop age-appropriate interventions, more research is needed to understand why families have difficulties accessing health care.
authors.affiliation: Department of Public Health and Health Sciences, University of Michigan-Flint, Flint, Michigan; International Institute, University of Michigan-Ann Arbor, Ann Arbor, Michigan. Electronic address: gergana.ucla@yahoo.com.
authors.forename: Gergana Damianova
authors.initials: GD
authors.lastname: Kodjebacheva
authors.affiliation: Department of Public Health and Health Sciences, University of Michigan-Flint, Flint, Michigan.
authors.forename: Tina
authors.initials: T
authors.lastname: Sabo
authors.affiliation: Department of Public Health and Health Sciences, University of Michigan-Flint, Flint, Michigan.
authors.forename: Shan
authors.initials: S
authors.lastname: Parker
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000191:economics; D017028:Caregivers; D002648:Child; D002662:Child Health Services / Q000191:economics / Q000706:statistics & numerical data; D002675:Child, Preschool; D005251:Fees, Medical; D005260:Female; D006297:Health Services Accessibility; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care; D044469:Racial Groups; D012959:Socioeconomic Factors