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10-06-2010 | Respiratory | Article

Universal health insurance coverage may not eliminate racial health disparities

Abstract

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MedWire News: Researchers have found significant racial disparities in asthma prevalence, treatment, and outcomes among children in the US Military Health System, which provides universal health insurance coverage.

The findings, published in the Archives of Pediatric and Adolescent Medicine, suggest that universal health insurance coverage alone is not enough to eliminate racial disparities in health care.

Kate Stewart (Mathematica Policy Research Inc, Chicago, Illinois, USA) and team studied data on 822,900 children, aged 2–17 years, enrolled throughout 2007 in TRICARE Prime, a health maintenance plan provided by the US Department of Defense.

Children in the age groups 2–4, 5–10, and 11–17 years were assessed for asthma prevalence, potentially avoidable asthma-related hospitalizations, asthma-related emergency department visits, visits to asthma specialists, and use of asthma medications.

The researchers found that racial and ethnic differences were apparent in several measures and age groups.

After adjustment for gender, number of siblings, area of residence, parental pay grade, and other variables, Black and Hispanic children in all age groups were significantly more likely to have asthma than White children, at odds ratios (ORs) ranging from1.16 to 2.00.

Black children in all age groups and Hispanic children aged 5–10 years were significantly more likely to have had potentially avoidable asthma-related hospitalizations and asthma-related emergency department visits than White children, at adjusted ORs ranging from 1.24 to 1.99. Black children in all age groups and Hispanic children aged 5–10 years were also significantly less likely to visit a specialist than were White children, at adjusted ORs between 0.71 and 0.88.

Furthermore, Black children in all age categories were significantly more likely to have filled any prescriptions for inhaled corticosteroids than White children, at an adjusted OR of 1.11.

Stewart and colleagues conclude: “Despite universal health insurance coverage and access to military treatment facilities, we found evidence of racial and ethnic differences in asthma prevalence and outcomes after adjusting for differences in demographic characteristics and socioeconomic status.”

They add: “Our findings suggest that eliminating racial and ethnic disparities in health care likely requires a multifaceted approach beyond universal health insurance coverage.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Mark Cowen

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