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Ethnic disparities in asthma treatment and outcomes in children aged under 15 years in New Zealand: analysis of national databases

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Authors:
Summary:

Using data from the national pharmaceutical claims database, these researchers identified 80,514 children aged <15 years dispensed >2 asthma medicines, in this investigation into the recommended treatment and outcomes for asthma in all New Zealand children by age, sex, and ethnic group. A total of 16.0% of children were dispensed asthma medicines, 9.2% were dispensed medicine >2 times, 3.6% were hospitalised at least once for asthma and 98.9% of admissions were acute. Māori (OR 1.46) and Pacific children (OR 2.38) were less likely to have their treatment escalated to a higher step than other children. At all steps of treatment, Māori and Pacific children were more likely to be using oral steroids to control asthma exacerbations and in all age groups, Māori children (5.1%; OR 1.88) and Pacific children (5.6%; OR 2.05) were more likely to be hospitalised for asthma than children of other ethnicities (2.8%).

Comment:
Research showing ethnic differences in asthma treatment was published in the 1980s by Professor Ed Mitchell and others, and reviewed again in the 1990s and early 2000s by Dr Sue Crengle. It is therefore extremely disheartening to see that asthma burden continues to fall heaviest on Māori children. I would like to acknowledge here too the recent passing of Wiremu Ngatiranginui Tukaokao Rawiri, the son of a good childhood friend of mine. Moe mai e tama.
Reference: Prim Care Respir J 2013;22(3):312-8
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

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