Asthma disparities in the prevalence, morbidity, and treatment of Latino children

University of Puerto Rico, Medical School San Juan, Puerto Rica.
Social Science & Medicine (Impact Factor: 2.89). 01/2007; 63(11):2926-37. DOI: 10.1016/j.socscimed.2006.07.017
Source: PubMed


The paper reviews the existing research related to asthma disparities and frames the results of this research within a conceptual model modified from the Institute of Medicine model in order to explain asthma health disparities in Latino children in the USA. The model of pediatric asthma disparity presented is based on the conceptualization of health disparities as the result of a complex interaction of factors related to four main domains: the individual and family, the environment or context in which the child lives, the health-care system, and provider characteristics. Asthma disparities are discussed as they are reflected in the process of care (access and quality of treatment) and outcome (prevalence, morbidity, severity) experienced by Latino children. The potential mechanisms that may account for the asthma disparities documented as reflected by the conceptual model proposed are discussed. Finally, several suggestions for future research examining determinants that account for asthma disparities are examined.

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Available from: Alexander N Ortega, Jul 21, 2014
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    • "Asthma prevalence among children and adolescents is estimated to be 9.6% overall, and is highest among non-Hispanic black children (17.0%) [2]. Hispanic/Latino and non-Hispanic black children have greater asthma-related risk exposures than non-Hispanic Whites, and are at higher risk for emergency department visits, hospitalizations, and death from asthma [3-6]. They exhibit lower adherence to medication and only about one-third report using long-term controller medicine or receiving asthma care plans from their clinicians [2]. "
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    ABSTRACT: Background Massive resources are expended every year on cross-cultural communication training for physicians. Such training is a focus of continuing medical education nationwide and is part of the curriculum of virtually every medical school in America. There is a pressing need for evidence regarding the effects on patients of cross-cultural communication training for physicians. There is a need to understand the added benefit of such training compared to more general communication. We know of no rigorous study that has assessed whether cross-cultural communication training for physicians results in better health outcomes for their patients. The current study aims to answer this question by enhancing the Physician Asthma Care Education (PACE) program to cross cultural communication (PACE Plus), and comparing the effect of the enhanced program to PACE on the health outcomes of African American and Latino/Hispanic children with asthma. Methods/Design A three-arm randomized control trial is used to compare PACE Plus, PACE, and usual care. Both PACE and PACE Plus are delivered in two, two-hour sessions over a period of two weeks to 5–10 primary care physicians who treat African American and Latino/Hispanic children with asthma. One hundred twelve physicians and 1060 of their pediatric patients were recruited who self-identify as African American or Latino/Hispanic and experience persistent asthma. Physicians were randomized into receiving either the PACE Plus or PACE intervention or into the control group. The comparative effectiveness of PACE and PACE Plus on clinician’s therapeutic and communication practices with the family/patient, children’s urgent care use for asthma, asthma control, and quality of life, and parent/caretaker satisfaction with physician performance will be assessed. Data are collected via telephone survey and medical record review at baseline, 9 months following the intervention, and 21 months following the intervention. Discussion This study aims to reduce disparities in asthma outcomes among African American and Latino/Hispanic children through cross-cultural communication training of their physicians and assessing the added value of this training compared to general communication. The results of this study will provide important information about the value of cross-cultural training in helping to address persistent racial disparities in outcomes. Trial registration NCT01251523 December 1, 2010
    BMC Medical Education 06/2014; 14(1):118. DOI:10.1186/1472-6920-14-118 · 1.22 Impact Factor
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    • "Over half, 52 percent, of all Hispanic children in the U.S. live in households burdened with high housing costs (The Annie E. Casey Foundation, 2013).The health disparity is also a factor in this population. Latino children in the US are significantly more likely to experience asthma and other health related challenges than their non-Latino peers (Canino, et al., 2006). Educational disparities also abound for Hispanic children in the U.S. Hispanic children are 9 percent less likely to attend preschool, 14 percent less likely to be proficient in reading and math in elementary school than the national average, and seven percent more Hispanic adolescents are not graduating from high school on time compared to the national average (The Annie E. Casey Foundation, 2013). "

    01/2014; 2(2). DOI:10.15640/jssw.v2n2a17
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    • "Puerto Rican children experience higher asthma prevalence rates and greater risk for asthma morbidity compared to children of other Latino ethnic groups, and to children of African-American (AA) and NLW backgrounds, even after accounting for socioeconomic status (Lara, Akinbami, Flores, & Morgenstern, 2006). A growing body of work supports the multidetermined nature of asthma disparities (Canino et al., 2006). Among ethnic minority youth, those residing in urban settings display even higher levels of asthma morbidity (e.g., more asthma-related emergency department visits) (Rand et al., 2000). "
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    ABSTRACT: The goal of this study is to identify individual, family/cultural, and illness-related protective factors that may minimize asthma morbidity in the context of multiple urban risks in a sample of inner-city children and families. Participating families are from African-American (33), Latino (51) and non-Latino white (47) backgrounds. A total of 131 children with asthma (56% male), ages 6-13 years and their primary caregivers were included. Analyses supported the relationship between cumulative risks and asthma morbidity across children of the sample. Protective processes functioned differently by ethnic group. For example, Latino families exhibited higher levels of family connectedness, and this was associated with lower levels of functional limitation due to asthma, in the context of risks. This study demonstrates the utility of examining multilevel protective processes that may guard against urban risks factors to decrease morbidity. Intervention programs for families from specific ethnic groups can be tailored to consider individual, family-based/cultural and illness-related supports that decrease stress and enhance aspects of asthma treatment.
    Journal of Pediatric Psychology 03/2012; 37(4):424-37. DOI:10.1093/jpepsy/jss002 · 2.91 Impact Factor
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