1. printed by www.postersession.com Asthma in Women of Color and/or Low Income Noreen M. Clark, PhD, Molly Gong, MD, Sijian Wang, MS, Melissa Valerio, MPH, William Bria, MD, Xihong Lin, PhD, Timothy Johnson, MD University of Michigan - School of Public Health RATIONALE: The purpose of this study was to compare management problems of women with asthma of different races and socioeconomic status. METHODS: Telephone interview data were collected from 590 participants attending asthma clinics within the University of Michigan Health System. 37% (n=160) were women of color and/or from low income families (less than $20,000). Poisson and Logistic regression models were conducted to ascertain group differences. RESULTS: Women of color were 4 times more likely to be at the low income level than white women (OR=4.0, p=.0001). Women of color and/or from low income families were 1.6 times more likely to have persistent disease (OR=1.6, p=.016), 4.9 hospitalizations (RR=4.9, p=.0001), 1.8 ED visits (RR=1.8, p=.002), 1.3 unscheduled urgent office visits (RR=1.3, p=.0007), and 1.5 follow-up visits for an asthma episode (RR=1.5, p=.006) compared to non- minority women and/or those of higher income. They used less inhaled corticosteroid medicine (OR=0.7, p=.025) and less long-acting inhaled bronchodilators (OR=0.6, p=.02). Although not statistically significant, they also used more oral steroids (OR=1.5, p=.1) and more home remedies (OR=1.7, p=.3). They also were more likely to have lower levels of self-esteem (p=.05), asthma knowledge (p=.01), and asthma-related quality of life (p=.02). Significantly more women of color and/or from low income families reported that they had never visited a specialist for asthma (OR=.06, p=.006) and were not satisfied with the medical care they received (OR=0.3, p=.05). CONCLUSION: Women of color and/or from low income families confront more asthma management difficulties and bear greater burden of the disease. Women of Color were more likely: To have more severe disease and use more health care. To use less controller medication. To have lower levels of self esteem, asthma knowledge, and perceptions of quality of life. Women of Color and/or low income bear a greater asthma burden. Supported by NHLBI grant 1R18 HL60884 Background: Asthma Continues to be an extensive problem in the Unites States. Women predominate among adults with asthma and confront particular problems in managing the disease. Studies indicate that women of color, especially from low income families, bear a significantly greater burden of asthma. Purpose: The purpose of this study was to compare management problems of women with asthma of different socioeconomic status Data Collection: Telephone interview data collected: DemographicMedication use Disease severityHealth care utilization Quality of life and self-esteem Data Analysis: Poisson and Logistic regression models controlling for age and disease severity and Chi-square or t-tests were performed to compare differences in outcomes between minority and/or low income women with non minority, non low income women. Study Participants: 806 women 18 years and older Physician diagnosis of asthma Cared for in the University of Michigan Health System ABSTRACT BACKGROUND & METHODS FINDINGS CONCLUSIONS Demographics: Comparison of Medication Use Comparison of quality of life, asthma knowledge, and self-esteem Age Comparison of Symptoms & Severity Education Level Comparison of Healthcare Providers: Significantly more Women of Color and/or low income reported that: They had never visited a specialist for asthma (OR=0.06, p=.006) They were not satisfied with the medical care they received (OR=0.3, p=.05) Annual Household Income Race/Ethnicity Women of Color and/or low income versus White, not low income: 27% of the participants were Women of Color and/or low income (<$20,000 annual family income) Women of Color were 4 times more likely to be at the low income level than White women (OR=4.0, p<.0001) Comparison of health care use Minority and/ or low income (N=156) White & not low income (N=433)p-value Yearly average days of daytime symptoms 6.1 (SD=5.9)4.6 (SD=5.5)<.05 Yearly Average nights of nighttime symptoms 4.3 (SD=4.9)3.1 (SD=4.1)<.05 Persistent Asthma (%) 56%45% OR=1.6.016 1 = Minority & low income 0 = White & not low incomeHospital admissionED visits Unscheduled Visits Follow-up visits Estimation 1.590.610.290.38 S.E. 0.300.200.090.14 Relative Risk 4.901.841.341.46 p-value <.0001.0019.0007.0055 Minority & low income (N=151) White & not low income (N=422)Odds Ratiop-value Inhaled anti- inflammatory medications 51%63%0.68.042 Inhaled corticosteroids 52%62%0.65.025 Long-acting inhaled bronchodilators 44%55%0.64.019 Home remedies5%3%1.660..3 1 = Minority & low income 0 = White & not low income Quality of lifeAsthma KnowledgeSelf-esteem Estimation 0.1779-0.1407-0.09 p-value 0.02190.050.049