Are racial healthcare disparities in healthcare access and utilization apparent or evident - a look at the Latino children suffering from asthma?

Objectives: To identify differences in healthcare utilization by race and Latino ethnicity among children with asthma and determine the relative contribution of predisposing, enabling, and unobserved factors in explaining these differences.

Methods: The California Health Interview Survey (CHIS) is a non-institutionalized household survey of California residents conducted bi-annually since 2001. Cross-sectional survey data were analyzed to identify differences by race and Latino ethnicity among children with asthma. After adjustment for sample weights and design effects, over 400,000 samples in the 2007 CHIS were calculated for children with asthma. Disparities in healthcare utilization across all race/ethnicity categories were analyzed using multivariate logistic regression and negative binomial regression analysis.

Results: Mexican children with asthma are 49% more likely to have an emergency room (ER) visit in the previous year (p<.04) and 58% less likely to have a doctor visit (p<.049) compared to White children with asthma after controlling for confounding variables. Among ethnicity groups, Latino ethnicity is 72% more likely to have an ER visit in the previous year and 38% less likely to have a doctor visit compared to non-Latino ethnicity. Negative binomial regression results show that Mexican race is negatively associated with number of doctor visits (p< .024).

Conclusion: The CHIS database offers an opportunity to investigate the occurrence of ER and doctor visits among children with asthma by race and ethnicity. This study shows that Mexican children are more likely to have an ER visit and less likely to have a doctor visit compared to White children.