Disparities in asthma--a comparison by insurance types: NHIS, United States 2003 and 2008

National data indicate that asthma prevalence and health care encounters are higher among certain demographic groups. The National Health Interview Survey (NHIS) asks about diagnosed asthma and about emergency department visits for asthma. Supplemental questions asked in 2003 and 2008 included asthma hospitalizations, use of rescue and control medications, school and work days lost, asthma education, and environmental changes to reduce trigger exposure. Demographic variations in asthma prevalence and care were examined using 2003 and 2008 NHIS data. Prevalence, ED visits, control medication and rescue medication use were compared by demographics and type of insurance. Results represent 2005, the midpoint between the two annual data sets. Current asthma prevalence was higher in children (9.0%) than adults (6.9%). Among children with private insurance, 8.1% reported current asthma and 11.9% with Medicaid/CHIP reported current asthma. Among adults, 6.4% with private insurance reported current asthma and 14.0% with Medicaid reported current asthma. Among those with current asthma, Hispanic and non-Hispanic blacks more frequently reported ED visits than did non-Hispanic whites. Adults reported use of rescue medication in the past 3 months (66.9%) more frequently than children (59.8%). Adults with Medicaid/CHIP reported excessive rescue medication use (more than 3 canisters in 3 months) more frequently (18.4%) than did those with private insurance (9.1%). Non-Hispanic whites more frequently reported current use of daily control medication (35.6%) than did non-Hispanic blacks (30.4%) and Hispanics (28.7%). The findings of this study suggest that socio-demographic differences in asthma management and health outcomes exist in the United States.