Disparities in health care utilization among Latino children suffering from asthma in California

Jongwha Chang^1*, Isha Patel^1*, Sherry T Liu², Alexander N Ortega³, Jatin Srivastava⁴, Yoon Shin Park⁵, Sarah Kirk⁶, Rajesh Balkrishnan^1,7,8

¹Department of Social and Administrative Science, University of Michigan, Ann Arbor, MI; ²College of Public Health, The Ohio State University, Columbus, OH; ³School of Public Health, University of California, Los Angeles, CA; ⁴EW Scripps School of Journalism, Ohio University, Athens, OH; ⁵Department of Pharmaceutical Science, University of Michigan, Ann Arbor, MI; ⁶Texas Asthma Control Program, Texas Department of State Health Services, Austin, TX; ⁷Center for Medication Use, Policy and Economics, ⁸Department of Health Management and Policy, University of Michigan, Ann Arbor, MI, USA
*Both authors contributed equally to this project.

Objectives: To examine any racial and ethnic differences in health care utilization among children with asthma by application of the Aday and Anderson’s behavioral model of health care utilization.
Methods: The California Health Interview Survey (CHIS) is a noninstitutionalized household survey of California residents conducted biannually since 2001. Cross-sectional survey data were analyzed to identify differences by race and ethnicity among children with asthma. After adjusting for sample weights and design effects, children with asthma comprised a sample size of 400,000 in the 2007 CHIS database. Disparities in health care utilization across all racial and ethnic categories were analyzed using multivariate logistic regression analysis.
Results: Latino children with asthma were 49% more likely to have visited an emergency department in the previous year (P < 0.05) and 57% less likely to have visited a doctor (P < 0.05) compared with non-Latino children with asthma, after controlling for confounding variables. Furthermore, Puerto Rican children were 72% more likely to have visited an emergency department (P < 0.05) in the previous year and 38% less likely to have visited a doctor (P < 0.07) compared with non-Puerto Rican children.
Conclusion: This study provides evidence of disparities in health care utilization among Latino children overall as well as in Latino children belonging to different subgroups suffering from asthma. Examining factors leading to differences within the Latino subgroups could help to guide the tailoring of interventions and health care programs for children with asthma, thereby improving access to health care services for this underrepresented minority.
Keywords: racial disparities, Latino children, Puerto Ricans, Cuban Americans, CHIS, Mexican Americans, asthma