Black and Hispanic children with asthma are less likely than their white counterparts to be taking daily medication meant to prevent asthma attacks, a U.S. study shows.
The findings, published in the medical journal Chest, suggest one reason for the generally poorer asthma control among minority children.
The study found that among 1,485 asthmatic children from four U.S. states, black children were twice as likely as white children to have gone to the emergency room for an asthma attack in the past year. Overall, 39 percent of black children had visited the ER, compared with 18 percent of white children.
Hispanic children fell in between, with 24 percent of parents reporting an ER visit in the past year.
Some clues to the disparity emerged when the researchers looked at the children’s medication use. Both black and Hispanic children were less likely to be taking inhaled corticosteroids - daily medication that is recommended for preventing attacks of breathlessness and wheezing in people with persistent asthma.
Among white children, one-third had used inhaled corticosteroids in the past 3 months. Those figures were 21 percent and 22 percent among black and Hispanic children, respectively.
Minority children were also more likely to be overusing quick-acting drugs designed to treat an asthma attack in progress: 26 percent of black children used such “rescue” inhalers on a daily basis, as did 19 percent of Hispanic children. That compared with 12 percent of white children.
The findings suggest that underuse of preventive medication may be a “significant factor” in the racial and ethnic disparities in children’s rates of ER visits and hospitalization for asthma, write the researchers, led by Dr. Deidre Crocker of the U.S. Centers for Disease Control and Prevention in Atlanta.
It is not entirely clear why the racial disparities exist, according to Crocker’s team.
Even after the researchers weighed factors like family income and insurance coverage, household smoking and children’s weight, race itself was still a factor in asthma control and medication use.
One potential reason, Crocker and her colleagues write, is the fact that black and Hispanic children are more likely than white children to get their medical care in an emergency room - where prescriptions for preventive asthma medication are less likely, compared with a doctor’s office.
However, they add, research also suggests that doctors may be less likely to prescribe inhaled corticosteroids to minority patients, and that minority parents tend to be more skeptical about the drugs’ safety than white parents are.
Whatever the reasons for the findings, Crocker’s team concludes, they show that more needs to be done to increase the use of preventive asthma medication among minority children and decrease their reliance on rescue inhalers.
SOURCE: Chest, October 2009.