McDaniel Marla K, Waldfogel Jane
Center on Labor, Human Services, and Population, Urban Institute, Washington, DC 20037, USA.
J Asthma. 2012 Oct;49(8):785-91. doi: 10.3109/02770903.2012.702840. Epub 2012 Jul 11.
We examined racial and ethnic differences in the management of childhood asthma in the United States and the extent that care conformed to clinical best practices.
Two years of pooled data from the National Health Interview Survey were analyzed using logistic regression. The sample included all children between ages 2 and 17 years who had asthma currently and had been diagnosed with asthma by a doctor or health professional (n = 1757; 465 African-American, 212 Mexican-American, 190 Puerto Rican and other Hispanic, 806 white, non-Hispanic, and 84 children of other and multiple races and ethnicities).
African-American children with asthma were significantly less likely than white, non-Hispanic children to have taken preventive asthma medication, but more likely to have had an asthma management plan. Mexican-American and Puerto Rican and other Hispanic children did not differ significantly from white, non-Hispanic children in either receiving preventive asthma medication or having an asthma management plan. Caregivers of African-American and Puerto Rican and other Hispanic children were more likely to report that they or their child had taken a course or class on how to manage their child's asthma. We did not find racial or ethnic differences in the extent children used quick-relief asthma medication or received advice about reducing asthma triggers in their home, school, or work environments.
This work highlights a need for more research on racial and ethnic differences in asthma management. Implications for public health responses and racial and ethnic disparities in asthma morbidity are discussed.
我们研究了美国儿童哮喘管理中的种族和民族差异,以及医疗护理符合临床最佳实践的程度。
使用逻辑回归分析了来自美国国家健康访谈调查的两年汇总数据。样本包括所有年龄在2至17岁之间、目前患有哮喘且已由医生或健康专业人员诊断为哮喘的儿童(n = 1757;465名非裔美国人、212名墨西哥裔美国人、190名波多黎各人和其他西班牙裔、806名非西班牙裔白人以及84名其他种族和多种族裔儿童)。
患有哮喘的非裔美国儿童服用预防性哮喘药物的可能性明显低于非西班牙裔白人儿童,但制定哮喘管理计划的可能性更高。墨西哥裔美国儿童、波多黎各儿童和其他西班牙裔儿童在接受预防性哮喘药物治疗或制定哮喘管理计划方面与非西班牙裔白人儿童没有显著差异。非裔美国儿童、波多黎各儿童和其他西班牙裔儿童的照顾者更有可能报告他们或他们的孩子参加过关于如何管理孩子哮喘的课程或班级。我们没有发现儿童使用速效哮喘药物或在家庭、学校或工作环境中接受减少哮喘触发因素建议的程度存在种族或民族差异。
这项研究强调需要对哮喘管理中的种族和民族差异进行更多研究。讨论了对公共卫生应对措施的影响以及哮喘发病率方面的种族和民族差异。