AfroAmerican and Hispanic* children seem to have a higher risk of developing asthma compared to Caucasian children; their outcomes are frequently worse, even within a comprehensive health insurance system, says a report published in Archives of Pediatrics & Adolescent Medicine, a JAMA/Archives journal.

* "Hispanic" in the USA tends to mean people of Latin American Amerindian ancestry, while in the UK the meaning includes all the Spanish-speaking world, including (mainly Caucasian) Spain. In this text, "Hispanic" means people of Latin American Amerindian ancestry.

The researchers wrote as background information that many factors contribute to well-documented racial and ethnic differences in children's health and health care. Universal health care coverage is widely considered an essential component of strategies to reduce these disparities.

The authors wrote:

Because the Military Health System provides comprehensive health insurance to a racially and ethnically diverse population of beneficiaries, studying disparities in health care treatments and outcomes among this population could add significantly to our understanding of the potential effect of universal coverage on reducing disparities in health care.

Kate A. Stewart, Ph.D., of Mathematica Policy Research, Chicago, and team studied data from 822,900 children aged 2 to 17 who were continuously enrolled throughout 2007 in TRICARE Prime, a Department of Defense health maintenance organization-type plan. Asthma prevalence, treatment patterns and outcomes were assessed among children age 2 to 4, 5 to 10 and 11 to 17.

Racial and ethnic differences were evident in numerous measures and age groups. AfroAmerican and Hispanic children were more likely to be diagnosed with asthma at all ages. AfroAmerican children of all ages and Hispanic children age 5 to 10 were more likely to have potentially avoidable asthma-related hospitalizations or emergency department visits.

The researchers wrote:

Our findings with regard to treatment patterns were mixed. Black children, who at all ages were more likely to have a diagnosis of asthma and to have poorer outcomes than white children, were also more likely to receive recommended asthma medications, especially inhaled corticosteroids.

However, this could be related to the higher rates of emergency department visits and potentially avoidable hospitalizations among these children, as drugs could have been prescribed and filled during or after these visits.

Details revealed that AfroAmerican children were also less likely to receive care from a specialist, who may be more inclined to treat asthma according to guidelines, including appropriate use of controller medications.

The authors wrote:

Thus, even though AfroAmerican children filled more prescriptions for asthma medications, they may have been less likely than white children who visited specialists to control their asthma and use the medications appropriately.