Health Service Deficits and School-Aged Children With Asthma: A Population-Based Study Using Data From the 2007-2008 National Survey of Child Health

• Published in: Journal of the National Medical Association Vol. 104; no. 5; pp. 275 - 285
• Main Authors: Lutfiyya, M. Nawal, PhD, McCullough, Joel Emery, MD, MPH, MS, Lipsky, Martin S., MD, MS
• Format: Journal Article
• Language: English
• Published: Washington, DC Elsevier Inc 01.05.2012; National Medical Association; Elsevier Limited
• Subjects: Adolescent; asthma; Asthma - epidemiology; Asthma - ethnology; Biological and medical sciences; Child; Child, Preschool; children/adolescents; Chronic obstructive pulmonary disease, asthma; Continental Population Groups - statistics & numerical data; Cross-Sectional Studies; Female; General aspects; health disparities; Health Expenditures; Health Surveys; Healthcare Disparities; Humans; Income; Internal Medicine; Male; Medical sciences; Miscellaneous; Multivariate Analysis; Pneumology; Prevalence; Public health. Hygiene; Public health. Hygiene-occupational medicine; Residence Characteristics; Risk Assessment; Risk Factors; United States - epidemiology; United States; children/adolescents; asthma; health disparities; Human; Lung disease; Respiratory disease; Health service; Statistical study; Asthma; Medicine; 2008; 2007; School age; Adolescent; Bronchus disease; Obstructive pulmonary disease; Child; Public health; Inequality
• ISSN: 0027-9684; 1943-4693
• DOI: 10.1016/S0027-9684(15)30157-7

Background Asthma is one of the most common and costly illnesses of childhood. This study addresses health services deficits experienced by school-aged children with asthma. Methods Analyzing data from the 2007-2008 National Survey of Child Health, this cross-sectional study used household income, race/ethnicity, and geographic residency as the primary independent variables and health service deficits as the dependent variable. Results Multivariate analysis yielded that other/multiracial (odds ratio [OR], 1.234; 95% confidence interval [CI], 1.226-1.242) and Hispanic (OR, 2.207; 95% CI, 1.226-1.242) schoolaged children with asthma had greater odds of having health services deficits as did both urban (OR, 1.106; 95% CI, 1.099-1.113) and rural (OR, 1.133; 95% CI, 1.124-1.142) schoolaged children with asthma. Children with either moderate (OR, 1.195; 95% CI, 1.184-1.207) or mild (OR, 1.445; 95% CI, 1.431-1.459) asthma had greater odds of having a health services deficit than those with severe asthma. Low-income school-aged children with asthma had greater odds of having a health services deficit than high-income children (OR, 1.031; 95% CI, 1.026-1.036). At lesser odds of having a health service deficit were those who were African American, of middle-range income, male, or who were school-aged children with asthma in good to excellent health. Conclusion Both African American and other/multiracial school-aged children were at greater risk of having asthma than either Caucasian or Hispanic children. Three vulnerable subgroups of school-aged children with asthma—rural, Hispanic, and those of low income were the most likely to have health service deficits.