The Impact of Poverty on Asthma Care Utilization Among Children: A Comprehensive Study

By Cailin Conner - August 25, 2023

Living in neighborhoods with income levels below 100% of the federal poverty line (FPL) was linked to an increased number of asthma-related medical visits, according to a study published in BMJ Family Medicine and Community Health.

Researchers examined the associations between various poverty measures (at the household and neighborhood levels) and the utilization of asthma care outcomes among children from Latino, non-Latino Black, and non-Latino White backgrounds within a community health center environment. To do so, they utilized electronic health record data from the OCHIN, Inc. network covering 2012-2017, which comprised >30,000 children with asthma.

Adjusted for covariates, generalized estimating equations were employed for logistic and negative binomial regression to analyze 3 specific outcomes: occurrence of ≥2 asthma visits per year, issuance of albuterol prescriptions, and prescription of inhaled corticosteroids.

Of the 30,196 children included in the analysis, 46% were Latino, 26% were non-Latino black, and 28% were non-Latino white. Most of the patients came from households with an income below 100% FPL; however, more than half of the participants (55%) lived in neighborhoods with an income exceeding 200% FPL.

Neighborhood poverty, defined as an income below 100% of the federal poverty level, was associated with increased asthma visits. Furthermore, residing in a low-income neighborhood (income ranging from 100-200% FPL) was associated with a higher rate of albuterol prescriptions. Albuterol is commonly used as a short-acting bronchodilator to relieve asthma symptoms.

The authors acknowledged some limitations of the study. The sample consisted entirely of patients from community health centers, with a significant portion belonging to low-income households. This could constrain the generalizability of the findings to patients seeking care at alternative clinics. However, “this does not limit its relevance,” the authors wrote, “as CHCs [community health centers] serve a disproportionate share of patients with asthma, with an emphasis on vulnerable populations with worse asthma outcomes.”

The researchers concluded, “Tools to measure both kinds of poverty (family and community) may already exist within clinics, and can both be used to better tailor asthma care and reduce disparities in primary care safety net settings.”

Source: BMJ Family Medicine and Community Health

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