“With the use of data from the Medicaid Management Information System, we estimated the prevalence of asthma hospitalization in the 5- to 14-year-old Michigan Medicaid population for the period 1980 to 1986… The largest increases were noted in urban black children, in which the rate more than doubled from 3.2 per 1000 in 1980 to 7.1 per 1000 in 1984. The adjusted relative risk for asthma hospitalization associated with….being black was 2.2 (95% CI: 2.1, 2.4).”

“Sly suggested that the management of asthma tends to be the poorest among patients with the poorest understanding of the disease and its treatment. Thus the large increases in asthma hospitalizations seen in our study could conceivably represent a failure in the health care system to deliver adequate care and education. To gain insight into this hypothesis we are currently looking into differences in the outpatient treatment of childhood asthma in the Michigan Medicaid population. Our preliminary results suggest that black urban residents received medical care more frequently, but obtained antiasthma drugs less frequently than other groups. In addition, black urban residents were prescribed large amounts of fixed-combination products well into the middle of the 1980s, whereas other groups more rapidly converted to more acceptable alternatives such as beta2-agonist inhalers. Thus at least an ecologic correlation appears to exist between black race and less modern asthma treatment modalities within the Michigan Medicaid population.”