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Ethnic and migrant differences in the use of anti-asthmatic medication for children: the effect of place of residence.

https://arctichealth.org/en/permalink/ahliterature105401
Source
Pharmacoepidemiol Drug Saf. 2014 Jan;23(1):95-104
Publication Type
Article
Date
Jan-2014
Author
Lourdes Cantarero-Arévalo
Annette Kjaer Ersbøll
Bjørn E Holstein
Anette Andersen
Susanne Kaae
Ebba Holme Hansen
Author Affiliation
Section for Social and Clinical Pharmacy, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Source
Pharmacoepidemiol Drug Saf. 2014 Jan;23(1):95-104
Date
Jan-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Anti-Asthmatic Agents - therapeutic use
Child
Child, Preschool
Denmark - ethnology
Ethnic Groups - ethnology
Female
Humans
Infant
Infant, Newborn
Male
Registries
Residence Characteristics
Transients and Migrants
Treatment Outcome
Abstract
Ethnic differences in the use of anti-asthmatic medication have been reported, with ethnic minorities being at a higher risk of suboptimal asthma control. As contextual socioeconomic characteristics may play a role, we analysed whether ethnic differences in the use of anti-asthmatic medication among children residing in the Capital Region of Denmark varied by place of residence.
Data were obtained from the Danish Civil Registration System, the Central Taxpayers' Register and the Danish National Prescription Register and were linked at the individual level. Population used was the entire child population in the Capital Region from 0 to 17?years old in 2008 (n?=?342,403). Use of anti-asthma medicine was defined as at least one prescription having been filled in 2008. The analyses included multiple multilevel logistic regression models.
Children living in low-income places of residence had lower odds of being prescribed preventive anti-asthmatics compared with children living in higher-income places of residence [odds ratio (OR)?=?0.87, 95% confidence interval (CI) 0.84-0.91]. Immigrant children had the lowest OR of being prescribed anti-asthmatics medication, both relief (OR?=?0.50, 95% CI 0.20-0.77) and preventive (OR?=?0.47, 95% CI 0.24-0.82) compared with ethnic Danes. Similar associations were found among descendants of immigrant children (OR for preventive medication?=?0.70, 95% CI 0.62-0.78). Place of residence contributed to but did not account for the ethnic differences in the use of anti-asthmatic medication.
Ethnic differences in the use of anti-asthmatic medication were documented, and they cannot be explained by socioeconomic characteristics of place of residence. The lower prevalence of anti-asthmatic medication among ethnic minority children suggests poor asthma management control.
PubMed ID
24395546 View in PubMed
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Inequalities in asthma treatment among children by country of birth and ancestry: a nationwide study in Denmark.

https://arctichealth.org/en/permalink/ahliterature112598
Source
J Epidemiol Community Health. 2013 Nov 1;67(11):912-7
Publication Type
Article
Date
Nov-1-2013
Author
Lourdes Cantarero-Arévalo
Bjørn Evald Holstein
Anette Andersen
Susanne Kaae
Marie Nørredam
Ebba Holme Hansen
Author Affiliation
Section for Social and Clinical Pharmacy, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, , Copenhagen, Denmark.
Source
J Epidemiol Community Health. 2013 Nov 1;67(11):912-7
Date
Nov-1-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Anti-Asthmatic Agents - therapeutic use
Asthma - drug therapy - ethnology
Denmark - epidemiology
Emigrants and Immigrants - statistics & numerical data
Ethnic Groups - statistics & numerical data
Female
Health Care Surveys
Health Services Accessibility
Humans
Logistic Models
Male
Middle Aged
Population Surveillance
Prescriptions
Prevalence
Primary Health Care - utilization
Quality of Health Care
Residence Characteristics
Socioeconomic Factors
Young Adult
Abstract
Investigations in several Western countries have reported ethnic differences in asthma prevalence and treatment among children and in some countries these differences are increasing. The aim of this study was to analyse whether there are inequalities in asthma treatment by country of birth and ancestry among children residing in Denmark, and whether this potential association may vary between different household income groups.
Data were obtained by linking the Danish Civil Registration System, the Central Taxpayers' Register and the Danish National Prescription Register.
the entire population of children in Denmark from 0 to 17 years of age in 2008 (n=1 209 091). Information on asthma treatment was obtained from the National Prescription Register. The analyses included multiple logistic regression models stratified by household income.
Compared with ethnic Danes, immigrant children had the lowest OR for redeeming a prescription for asthma medication, both relief (OR 0.37; 95% CIs, 0.20 to 0.68) and preventive (OR 0.37; (0.22 to 0.59)). Similar associations were found among descendant children (OR for relief treatment 0.82 (0.79 to 0.89) and for preventive treatment 0.68 (0.61 to 0.75)). The pattern of the association remained after stratifying for household income.
We found that, inequalities that cannot be explained by household income alone exist in treatments to prevent asthma as well as to relieve symptoms in children residing in Denmark, by country of birth and ancestry. The difference between immigrants and descendants may indicate that unfamiliarity with the Danish healthcare system is a contributory cause of the inadequate treatment of asthma.
PubMed ID
23814271 View in PubMed
Less detail