Emergency department visits by urban African American children with asthma

Background: Asthma morbidity among African American children has been ident ified as a significant national health concern. High emergency department u se is one index of this morbidity and may reflect disease severity, disease management, and social factors. Objective: This study examined the prevalence and correlates of emergency d epartment use and other indices of asthma morbidity among a sample of urban , low-income, African American children. Methods: Parents of 392 elementary school children with asthma who had cons ented to participate in an asthma education program were interviewed by pho ne according to a standardized protocol. Results: Children had a mean of 6.2 days of restricted activity (SD 8.1) an d 7.9 symptomatic nights (SD 8.1), The mean number of school days missed be cause of asthma was 9.7 (SD 13.5). Among children with asthma symptoms in t he past 12 months, 73.2% could identify a specific physician or nurse who p rovided asthma care. For those families without an identified asthma primar y care provider, 39.3% received their usual asthma care from the emergency department. A total of 43.6% of the children had been to the emergency depa rtment for asthma care without hospitalization in the previous 6 months, Cl ose to 80% of children reported using one or more prescribed asthma medicat ion, and of these only 12% reported using inhaled anti-inflammatory medicat ions. Families of children who had used the emergency department in the pri or 6 months reported more asthma symptoms, lower social support, problems p aying for health care, and the absence of a hypoallergenic mattress cover a nd that they had seen a physician for regular asthma care in the past 6 mon ths. Conclusions: We conclude that asthma management for children in the inner c ity relies on episodic care and emergency care, that asthma medication mana gement does not conform to current guidelines, and that asthma symptoms res ulting in school absences and workdays Lost are prevalent.