Racial and Socioeconomic Disparities in Pediatric Asthma Emergency Care

Abstract

The aim of this paper is to build a model to compare the relative impact of race and ethnicity and insurance type on pediatric Emergency Department utilization for asthma. A binary logistic regression model using relevant variables from 2022 NHIS survey data was conducted to compare asthma ED visit odds ratios of racial and ethnic minorities and publicly insured children. The results suggest that insurance type has slightly greater influence over asthma ED visits than race and ethnicity. Publicly insured children had the highest unadjusted odds ratio (1.88 [CI 95% 1.09-3.24)]) followed by Non-Hispanic Black children (1.80 [0.92-3.52]) and Hispanic children (1.51 [0.80-2.86]). The data are possibly biased toward exclusion of well-controlled asthmatics that may affect the resulting odds ratios. More socioeconomic variables would provide a more complete analysis. The paper has direct implications for health service providers and policymakers. Providers are encouraged to provide equitable, culturally competent care to asthmatics and policymakers are encouraged to embrace policies that promote better access for Medicaid beneficiaries, improved air quality and housing conditions for low-income children, and better racial representation in the provider workforce. The paper collates many existing sources of research on asthma disparities as a backdrop for examination of recent survey data pertaining to differences in asthma ED utilization between populations. It supports existing theories and work being done to mitigate poor asthma outcomes in children that are exacerbated by biological and systemic factors.

Keywords

• Health services
• Quality management
• Emergency Department
• Asthma

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