Investigators hope that continued research and addressing disparities can improve equitable access to asthma treatments for all pediatric patients.
Emergency medical services (EMS) are less likely to transport Black children to the hospital for an asthma episode compared to White children, according to a study published in the journal Prehospital Emergency Care. The investigative team, comprised of members from the University of Pittsburgh and researcher-physicians at UPMC, also observed that Black children are more likely to experience a severe asthma episode, as this may reflect differences in socioeconomic status or other external factors.
Asthma is a condition that affects approximately 25 million people in the United States. Resulting in shortness of breath, chest tightness, and wheezing, it is the leading cause of death in children. But according to 2020 data, Black children are 3 times more likely to die from asthma-related causes than White children. The investigators conducted a study to understand how EMS members managed and treated children with asthma in the pre-hospital setting.
“We have a lot of data on hospital management of childhood asthma but very little information to show how well we are treating asthma in the pre-hospital environment or if there are disparities,” said primary study author Sylvia Owusu-Ansah, MD, a pediatric emergency medicine physician and the medical director of EMS at UPMC Children’s Hospital of Pittsburgh, in a press release.
Using a national database, the team analyzed 5266 EMS encounters with children aged 2 to 17 years. Of the patient population—which included 53% non-Hispanic Black children and 34% non-Hispanic White children—Black children were less likely to be transported to a hospital.
According to Owusu-Ansah, these patients may not recognize the severity of their illness, which may impact their decision to be driven to the hospital. Alternatively, these patients may have a general mistrust of health care or fear hospitalization, which can contribute to a reduced likelihood of being driven to the hospital.
“Patients may need to be transported to a hospital for further evaluation and care and we don’t want people avoiding that follow-up care if it’s crucial to supporting their health and wellness,” Owusu-Ansah said in the press release.
Conversely, Black children were more likely to be treated with a bronchodilator. This is significant because bronchodilators are used for more severe disease, which may indicate that a higher number of Black children have asthma compared to White children.
Having a baseline understanding of how social determinants of health (SDOH) can affect pre-hospital treatment and transport opens the door for future research opportunities. The medical director plans to further these studies in the pre-hospital setting because health care providers can interact with patients in a different way than they can in a hospital setting.
“As first responders, EMS has the first look at the patient and their home, so they can observe whether there is mold or other factors that contribute to a patient’s illness,” Owusu-Ansah said the press release. “A patient may not share that information with their doctor. But EMS can pick up on small details that may be important when treating a patient and have huge opportunity to make a difference.”
University of Pittsburgh. New study finds disparities among management of pediatric chronic asthma. News Release. September 26, 2023. Accessed on October 9, 2023. https://www.eurekalert.org/news-releases/1002747