Racial and Ethnic Disparities in Emergency Department Visits for Children with Asthma in Houston

Objective: Identifying key factors that contribute to care sought in emergency departments (EDs) by the asthma population is essential for improving asthma disparities. Therefore, the purpose of this study was to examine factors associated with high ED utilization for asthma among children in Houston, Texas. Identifying these key factors will assist with this study with understanding why disparities continue to exist and who is at greatest risk. Methods: In a retrospective, cross-sectional study, 704,902 ED visits at 23 hospitals in Houston, Texas, from January 1, 2005 to December 31, 2007 made by children 18 and younger were examined. Bivariate and multivariate logistic regression models and mixed effects models were used to determine variables that were predictors for increased asthma-related ED visits. Results: Of the 704,902 ED visits made by children, 19,098 (3%) had a primary discharge diagnosis of asthma. African-American children were 2.6 (95% CI, 2.43-2.66) times more likely to have an ED visit for asthma compared to White children. Poverty (OR = 1.01, 95% CI 1.01-1.02), single parent headed households (OR = 1.67 95% CI 1.39-2.01), and children between the ages of 5-9 (OR = 1.96, 95% CI 1.89-2.03) were all predictors for increased ED visits for asthma treatment. Conclusion: African American children were almost 3 times more likely to have an ED visit for asthma. Efforts to reduce the disparities in asthma among children may need to focus on targeted interventions aimed at low-income, single-parent, African American families, accounting for culturally relevance.