PEDIATRICS Vol. 115 No. 5 May 2005, pp. 1254-1260 (doi:10.1542/peds.2004-0897)
Racial and Ethnic Differences in Asthma Diagnosis Among Children Who Wheeze
* Infant, Child, and Women's Health Studies Branch, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
Department of Pediatrics and Rand Health, University of California, Los Angeles/Rand Program on Latino Children With Asthma, Los Angeles, California
Background. Racial and ethnic disparities exist in reported childhood asthma prevalence, but it is unclear if disparities stem from true prevalence differences or a different likelihood of receiving a diagnosis from a health professional. Concern has been raised that asthma may be underdiagnosed, particularly among minority children who have more restricted access to high-quality health care.
Objective. To examine racial/ethnic differences among currently symptomatic children in acquiring an asthma diagnosis to determine if relative underdiagnosis among minorities exists. Children for whom no symptoms were reported (a group that includes those with well-controlled symptoms) were excluded from the analysis.
Methods. The 1999 National Health Interview Survey includes a nationally representative sample of children with reported wheezing symptoms. We included children 3 to 17 years old in the study and analyzed racial/ethnic differences in asthma diagnosis, controlling for young age, gender, parental education, single-parent household, central-city residence, region of residence, health insurance, having a usual place of care, and parent-reported severity of wheezing symptoms.
Results. Among those reported to have wheezed in the past year (n = 946), 83% of Puerto Rican, 71% of non-Hispanic black, and 65% of Mexican children were diagnosed with asthma compared with 57% of non-Hispanic white children. Using non-Hispanic white children as the reference group, the approximate adjusted relative risk for physician diagnosis of asthma given wheezing in the past year was 1.43 (95% confidence interval [CI]: 1.04, 1.63) for Puerto Rican, 1.22 (95% CI: 1.03, 1.37) for non-Hispanic black, and 1.19 (95% CI: 0.94, 1.39) for Mexican children. Minority children were reported to have greater severity of wheezing symptoms. Even after accounting for this increased severity, children in racial and ethnic minority groups were as or more likely to have a reported asthma diagnosis than non-Hispanic white children.
Conclusions. Our findings do not provide evidence for the hypothesis that symptomatic minority children are underdiagnosed with asthma compared with non-Hispanic white children. To the contrary, among currently symptomatic children, minority children were more likely to be diagnosed than non-Hispanic white children even after accounting for the higher wheezing severity among minority children.
Key Words: asthma • ethnic disparity • prevalence • racial differences • wheezing
Abbreviations: NHIS, National Health Interview Survey • NAEPP, National Asthma Education and Prevention Program
Accepted Aug 31, 2004.
CiteULike 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
This article has been cited by other articles:
|
|
 |
|
  D. Crocker, C. Brown, R. Moolenaar, J. Moorman, C. Bailey, D. Mannino, and F. Holguin Racial and Ethnic Disparities in Asthma Medication Usage and Health-Care Utilization: Data From the National Asthma Survey Chest, October 1, 2009; 136(4): 1063 - 1071. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. V. James and S. Rosenbaum Paying for Quality Care: Implications for Racial and Ethnic Health Disparities in Pediatric Asthma Pediatrics, March 1, 2009; 123(Supplement_3): S205 - S210. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Panico, M. Bartley, M. Marmot, J. Y Nazroo, A. Sacker, and Y. J Kelly Ethnic variation in childhood asthma and wheezing illnesses: findings from the Millennium Cohort Study Int. J. Epidemiol., October 1, 2007; 36(5): 1093 - 1102. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. T. Cohen, G. J. Canino, H. R. Bird, S. Shen, B. A. Rosner, and J. C. Celedon Area of Residence, Birthplace, and Asthma in Puerto Rican Children Chest, May 1, 2007; 131(5): 1331 - 1338. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Choudhry, E. G. Burchard, L. N. Borrell, H. Tang, I. Gomez, M. Naqvi, S. Nazario, A. Torres, J. Casal, J. C. Martinez-Cruzado, et al. Ancestry-Environment Interactions and Asthma Risk among Puerto Ricans Am. J. Respir. Crit. Care Med., November 15, 2006; 174(10): 1088 - 1093. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M. Davis, R. Kreutzer, M. Lipsett, G. King, and N. Shaikh Asthma Prevalence in Hispanic and Asian American Ethnic Subgroups: Results From the California Healthy Kids Survey Pediatrics, August 1, 2006; 118(2): e363 - e370. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Randolph Racial and Ethnic Differences in Asthma Diagnosis Among Children Who Wheeze Pediatrics, August 1, 2006; 118(Supplement_1): S39 - S40. [Abstract] [PDF]
|
|
|
|
|
|
G. M. Hunninghake, S. T. Weiss, and J. C. Celedon Asthma in Hispanics Am. J. Respir. Crit. Care Med., January 15, 2006; 173(2): 143 - 163. [Abstract] [Full Text] [PDF]
|
|
