Race and asthma outcomes in older adults: Results from the National Asthma Survey

Abstract

The number of older adults with asthma continues to rise, yet the effects of race and ethnicity on asthma outcomes in this population are unknown. Our goal was to examine these effects in a national sample. Data from the 2015 Behavioral Risk Factor Surveillance Survey (BRFSS) and Asthma Call-Back survey (ACBS) were analyzed. Respondents were included if they had a current asthma diagnosis, were aged ≥55, and self-identified as Non-Hispanic White, African American, or Hispanic. Demographic variables, healthcare access, and asthma history were correlated with asthma outcomes (healthcare utilization and asthma control). Asthma outcome variables were further analyzed using multivariable logistic regression. 4,700 individuals were included. Compared to Non-Hispanic White respondents, African American and Hispanic respondents had lower incomes, greater impaired access to healthcare due to cost, and increased reliance on rescue medications. After controlling for factors including income, education, and health insurance, African American and Hispanic respondents were twice as likely to visit the Emergency Room (ER) for asthma (P<0.001 for both) yet 40% less likely to report uncontrolled daytime symptoms (P=0.004 and P=0.006). Racial differences in asthma outcomes persist despite controlling for multiple social determinants of health and access to health insurance through Medicare. Minority patients were more likely to visit the ER but less likely to report frequent daytime symptoms. These findings indicate that comprehensive strategies to address assessment, monitoring, and treatment are needed to decrease health disparities.