Inadequate access to care among children with asthma from Spanish-speaking families

Despite substantial asthma prevalence and morbidity, children from Spanish-speaking families are at high risk of inadequate maintenance therapy. The reasons for this remain unclear. The objective of this study was to compare patterns of asthma morbidity and access to care of children with asthma from Spanish-speaking and English-speaking families. Cross-sectional data from a nationally representative sample of children with asthma 2-17 years of age were analyzed from the 1999 National Health Interview Survey, conducted in both English and Spanish, with the preferred language identified at the time of the interview. Among the 1,228 children with asthma (physician-diagnosed asthma by parent report), 66 (3%) were from Spanish-speaking families and 1,162 (97%) were from English-speaking families. In a logistic regression model adjusting for gender, insurance, poverty (above or below the federal poverty level, based on reported family income and the U.S. Poverty Threshold produced annually by the Census Bureau), and race/ethnicity, children with asthma from Spanish-speaking families were one-third less likely to have a usual health care provider (odds ratio [OR] 0.31, 95% confidence interval [CI] 0.1-0.8) than children with asthma from English-speaking families. Latino ethnicity was not independently associated with diminished continuity of care. These data indicate that children with asthma from Spanish-speaking families are less likely to experience continuity of health care than their counterparts from English-speaking families. Differences in continuity of care may contribute to inadequate asthma maintenance therapy among these children.