Racial and income disparities in childhood asthma in the United States

Lara J. Akinbami, Bonnie J. LaFleur, Kenneth C. Schoendorf

Research output: Contribution to journalArticlepeer-review

126 Scopus citations


Objective. - To examine racial and income disparities in asthma prevalence in US children, and disparities in morbidity and ambulatory health care use among children with asthma. Methods. - Using 1993-1996 National Health Interview Survey data, we measured asthma prevalence and morbidity in children aged 3 to 17 years (N = 14211) stratifying by race and poverty status. Measures of morbidity included asthma-related activity limitation and number of bed days. We used the ratio of asthma-related doctor contacts to number of bed days in the past 2 weeks to measure health care use adjusted for severity of illness. Results. - An annual average of 7.4% of children aged 3 to 17 years had asthma. There were no significant differences in asthma prevalence between race and poverty groups. In contrast, asthma-related morbidity was higher among black and poor children. Black poor children were most likely to have activity limitations due to asthma: 49% were limited compared with about 20% of black nonpoor, white poor, and white nonpoor children. Among children with activity limitations, black children and white poor children were more likely to have severe limitations, and white nonpoor children were least likely. Finally, white nonpoor children had the highest level of ambulatory care use for asthma after accounting for disease severity, and black poor children had the lowest level. Conclusions. - We found no significant racial or income disparities in asthma prevalence among children in the United States. However, black children and poor children are at higher risk for activity limitation, more severe activity limitation, and relative underuse of ambulatory health care. Black children living in poverty are at highest risk. Targeted interventions to reduce the burden of asthma morbidity in this population are likely to reduce disparities in asthma morbidity as well as reduce overall childhood asthma morbidity.

Original languageEnglish (US)
Pages (from-to)382-387
Number of pages6
JournalAmbulatory Pediatrics
Issue number5
StatePublished - 2002
Externally publishedYes


  • Asthma
  • Child
  • Health disparities
  • Income
  • Race

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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