abstract: 'BACKGROUND AND OBJECTIVES: Health care reform offers a new opportunity

  to address child health disparities. This study sought to characterize

  racial differences in pediatric asthma readmissions with a focus on the

  potential explanatory role of hardships that might be addressed in

  future patient care models.

  METHODS: We enrolled 774 children, aged 1 to 16 years, admitted for

  asthma or bronchodilator-responsive wheezing in a population-based

  prospective observational cohort. The outcome was time to readmission.

  Child race, socioeconomic status (measured by lower income and caregiver

  educational attainment), and hardship (caregivers looking for work,

  having no one to borrow money from, not owning a car or home, and being

  single/never married) were recorded. Analyses used Cox proportional

  hazards.

  RESULTS: The cohort was 57\% African American, 33\% white, and 10\%

  multiracial/other; 19\% were readmitted within 12 months. After

  adjustment for asthma severity classification, African Americans were

  twice as likely to be readmitted as whites (hazard ratio: 1.98; 95\%

  confidence interval: 1.42 to 2.77). Compared with whites, African

  American caregivers were significantly more likely to report lower

  income and educational attainment, difficulty finding work, having no

  one to borrow money from, not owning a car or home, and being

  single/never married (all P <= .01). Hardships explained 41\% of the

  observed racial disparity in readmission; jointly, socioeconomic status

  and hardship explained 49\%.

  CONCLUSIONS: African American children were twice as likely to be

  readmitted as white children; hardships explained > 40\% of this

  disparity. Additional factors (eg, pollution, tobacco exposure, housing

  quality) may explain residual disparities. Targeted interventions could

  help achieve greater child health equity.'
affiliation: 'Beck, AF (Corresponding Author), 3333 Burnet Ave,ML 7035, Cincinnati,
  OH 45229 USA.

  Beck, Andrew F.; Sauers, Hadley S.; Newman, Nicholas C.; Kahn, Robert S., Cincinnati
  Childrens Hosp Med Ctr, Div Gen \& Community Pediat, Cincinnati, OH 45229 USA.

  Beck, Andrew F.; Simmons, Jeffrey M.; Sauers, Hadley S., Cincinnati Childrens Hosp
  Med Ctr, Div Hosp Med, Cincinnati, OH 45229 USA.

  Moncrief, Terri, Cincinnati Childrens Hosp Med Ctr, Dept Pediat, Div Allergy \&
  Immunol, Cincinnati, OH 45229 USA.

  Huang, Bin; Chen, Chen; Ryan, Patrick H., Cincinnati Childrens Hosp Med Ctr, Dept
  Pediat, Div Biostat \& Epidemiol, Cincinnati, OH 45229 USA.'
author: Beck, Andrew F. and Huang, Bin and Simmons, Jeffrey M. and Moncrief, Terri
  and Sauers, Hadley S. and Chen, Chen and Ryan, Patrick H. and Newman, Nicholas C.
  and Kahn, Robert S.
author-email: andrew.beck1@cchmc.org
author_list:
- family: Beck
  given: Andrew F.
- family: Huang
  given: Bin
- family: Simmons
  given: Jeffrey M.
- family: Moncrief
  given: Terri
- family: Sauers
  given: Hadley S.
- family: Chen
  given: Chen
- family: Ryan
  given: Patrick H.
- family: Newman
  given: Nicholas C.
- family: Kahn
  given: Robert S.
da: '2023-09-28'
doi: 10.1542/peds.2013-2437
eissn: 1098-4275
files: []
issn: 0031-4005
journal: PEDIATRICS
keywords: childhood asthma; readmissions; racial disparities; pediatrics
keywords-plus: 'HEALTH-CARE; HOSPITAL READMISSIONS; CHILDHOOD ASTHMA; UNITED-STATES;

  CHILDREN; POPULATION; OUTCOMES; QUALITY; RISK; DETERMINANTS'
language: English
month: MAR
number: '3'
number-of-cited-references: '54'
orcid-numbers: 'Huang, Bin/0000-0001-9724-675X

  Newman, Nicholas/0000-0003-1963-4006

  Sauers-Ford, Hadley/0000-0002-7218-2953'
pages: 431-439
papis_id: 43fca090b8abe72f61a8aa1c5f90bbbe
ref: Beck2014rolefinancial
researcherid-numbers: 'Ryan, Patrick/HDO-1133-2022

  Ryan, Patrick H/L-7062-2015

  Huang, Bin/G-2468-2014

  Huang, Bin/U-2867-2019

  Newman, Nicholas/J-9066-2019

  '
times-cited: '117'
title: Role of Financial and Social Hardships in Asthma Racial Disparities
type: Article
unique-id: WOS:000335330700010
usage-count-last-180-days: '0'
usage-count-since-2013: '33'
volume: '133'
web-of-science-categories: Pediatrics
year: '2014'