"Income Disparities In Asthma Burden and Care In California"

According to a new report by the UCLA Center for Health Policy Research entitled, "Income Disparities In Asthma Burden and Care In California," asthma is increasing in California. Between 2001 and 2007, the prevalence of asthma increased significantly and by 2007 nearly five million Californians had been diagnosed with this chronic condition. Although asthma occurs among Californians at all socio-economic levels, it disproportionately affects low-income Californians, who miss more days of work and school, are more likely to have frequent asthma symptoms, and are more likely to go to the emergency department or be hospitalized for asthma care.
Key findings of this report include:

Asthma is widespread and increasing in California

• Lifetime asthma prevalence has increased from 11.3% to 13% between 2001 and 2007 among California adults.
• Current asthma prevalence varies considerably by county, ranging from 6% in San Francisco County to 12.9% in Fresno County (among Californians age 1 and over).
 • Lake, Tehama/Glenn/Colusa, Sutter, Yuba, Contra Costa, Solano, Sacramento, Fresno, Kern, Merced,
Madera and San Bernardino counties all had current asthma rates significantly higher than that of the state.

Asthma disproportionately affects vulnerable Californians

• 8.7% of Californians with incomes below 200% of the Federal Poverty Level (FPL) have current asthma, compared to 7.8% of those with incomes at or above 400% FPL.
• 31.9% of low-income California adults with current asthma experience asthma symptoms at least once a week compared to just 19.3% of their higher-income counterparts.
• Low-income Californians with current asthma are more likely to be children and people of color.

Asthma impacts productivity of low-income Californians

• Low-income children with current asthma miss more than twice as many days of school due to asthma as higher-income children (2.8 vs. 1.3 days).
• Low-income adults with current asthma miss three times as many work days as higher-income adults (2.2 vs. 0.6 days).

Emergency department visits and hospitalizations due to asthma are higher among low-income Californians

• Among families with incomes below 200% FPL, 18.8% of adults and 23.9% of children went to an emergency department or urgent care facility in the past year because of their asthma, compared with just 8.8% and 12.5% of their more affluent counterparts, respectively.
• Hospitalization rates among low-income Californians with current asthma were more than five times higher than the rates among their high income counterparts (6.5% vs. 1% for adults and 5.8% vs. 1.1% for children).

Low-income Californians with asthma are more likely to be uninsured and lack access to appropriate asthma care

• 22.1% of low-income California adults and children with current asthma were uninsured all or part of the past year compared with 4.4% of higher-income Californians.

• Low-income California adults and children with current asthma are less likely to get an asthma management plan than higher-income Californians.
• Low-income Californians are more likely to have no usual source of care and have difficulty understanding their doctor.

Low-income Californians are more likely to encounter risk factors for asthma exacerbation

• Rates of exposure to second-hand smoke are more than three times as high among low-income Californians with current asthma compared to their higher-income counterparts (13.5% vs. 4%).

(UCLA Center for Health Policy Research, Executive Summary)