Association of Early Childhood Wheeze and Asthma Diagnosis Documentation by Race, Ethnicity, and Language in Children

Jennifer A. Lucas; Miguel Marino; Michelle Trivedi; Roopradha Datta; David Ezekiel-Herrera; Steffani R. Bailey; Sophia Giebultowicz; John Heintzman

doi:10.3122/jabfm.2023.230115R1

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Figure 1.
Odds ratios of asthma diagnosis after age 4 by race, ethnicity, language groups. Generalized estimating equation models adjusted for sex, visits per year, income, insurance, body mass index, and household smoke exposure before age 4.

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Table 1.

Characteristics of Community Health Center Patients, 2005–2017 (n = 71,259)

	Latino, English-Preferring	Latino, Spanish-Preferring	Non-Latino Black	Non-Latino White
N (%)	15,160 (21.3)	25,383 (35.6)	12,557 (17.6)	18,159 (25.5)
Male, N (%)	7,626 (50.3)	12,717 (50.1)	6,293 (50.1)	9,137 (50.3)
Type of insurance, N (%)
Never insured	248 (1.6)	976 (3.9)	289 (2.3)	402 (2.2)
Some private	514 (3.4)	307 (1.2)	327 (2.6)	2,453 (13.5)
Some public	12,939 (85.4)	22,767 (89.7)	11,183 (89.1)	12,978 (71.5)
Some private and public	1,459 (9.6)	1,333 (5.3)	758 (6.0)	2,326 (12.8)
Visits per year, N (%)
<1	1,960 (12.9)	2,171 (8.6)	2,243 (17.9)	2,960 (16.3)
1 to 2	8,022 (52.9)	12,268 (48.3)	7,368 (58.6)	9,792 (53.9)
3 to 4	3,567 (25.5)	7,375 (29.1)	2,234 (17.8)	3,765 (20.7)
5 or more	1,611 (10.6)	5,369 (14.1)	712 (5.7)	1,642 (9.0)
Visits per year after the 4^th birthday, N (%)
<1	3,049 (21.0)	3,615 (14.8)	3,280 (26.9)	4,402 (25.2)
1 to 2	7,156 (47.2)	12501 (51.2)	6,442 (52.9)	8,599 (49.2)
3 to 4	2,715 (18.7)	5,325 (21.8)	1,652 (13.6)	2,866 (16.4)
5 or more	1,633 (11.2)	2,973 (12.2)	813 (6.7)	1,692 (9.3)
Income (FPL), N (%)
Always ≥138%	913 (6.0)	907 (3.6)	1,358 (10.8)	2,057 (11.3)
Always <138%	9,986 (65.9)	18,044 (71.1)	8,538 (68.0)	9,960 (53.2)
Above and below 138%	1,721 (11.4)	4,164 (16.4)	1,331 (10.6)	2,831 (15.6)
Never documented	2,540 (16.8)	2,268 (8.9)	1,330 (10.6)	3,611 (19.9)
Body Mass Index, N (%)
Never overweight/obese	6,735 (44.3)	9,842 (38.8)	6,722 (53.5)	9,670 (52.3)
Sometimes overweight/obese	6,082 (40.1)	11,475 (45.2)	4,203 (33.5)	6,090 (33.5)
Always overweight/obese	2,051 (13.5)	3,761 (14.8)	1,242 (9.9)	1,784 (9.8)
Never measured	292 (1.9)	305 (1.2)	390 (3.1)	615 (3.4)
Household smoking exposure age before age 4 N (%)	702 (4.6)	743 (2.9)	596 (4.8)	2,532 (13.9)
Wheeze diagnosis before age 4, N (%)	296 (2.0)	683 (2.7)	197 (1.6)	374 (2.1)
Asthma diagnosis after the 4^th birthday, N (%)	2,937 (19.4)	4,829 (19.0)	2,311 (18.4)	3,127 (17.2)

Abbreviation: FPL, federal poverty level.

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Table 2.

Adjusted Prevalence of ICD-Coded Asthma Diagnosis in the Electronic Health Record after Age 4, Stratified by Presence of Early Childhood Wheeze

	Adjusted Prevalence (95% CI)
Without early childhood wheeze
Latino, English-preferring	0.17 (0.16-0.18)
Latino, Spanish-preferring	0.16 (0.15-0.17)
Non-Latino Black	0.20 (0.18-0.21)
Non-Latino White	0.17 (0.16-0.18)
With early childhood wheeze
Latino, English-preferring	0.29 (0.24-0.34)
Latino, Spanish-preferring	0.26 (0.24-0.29)
Non-Latino Black	0.35 (0.28-0.41)
Non-Latino White	0.29 (0.24-0.34)