nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
See here for more discussion.

Thursday, June 10, 2010

Higher Disease Rates Not Always About Poverty And Lack Of Coverage

Population health research often identifies socioeconomic and ethnic factors involved in explaining differences in health care outcomes.  But the solution applied to those findings may not be simple.

A study of children of military personnel, amounting to about 800,000 patients, found that there were differences in rates of asthma between ethnic groups.  On the other hand, minorities were found to have higher rates of treatment with appropriate medications than whites.
"Black children, who at all ages were more likely to have a diagnosis of asthma and to have poorer outcomes than white children, were also more likely to receive recommended asthma medications, especially inhaled corticosteroids."
All the children were covered by the same insurance program for the military.  The only puzzling finding was whites more often saw allergy specialists, but I couldn't find that it was an issue of minority children not being referred as often.  The researchers didn't make the case that there was any difference in access or availability of specialists.

As the authors comment in a Bloomberg BusinessWeek article (June 7)
"Our findings suggest that eliminating racial and ethnic disparities in health care likely requires a multifaceted approach beyond universal health insurance coverage."
For Onion Peelers, (skip if math is not your thing)
Black and Hispanic children in all age groups were significantly more likely to have an asthma diagnosis than white children (ranging from odds ratio [OR] = 1.16; 95% confidence interval [CI], 1.09-1.24; to OR = 2.00; 95% CI, 1.93-2.07). They were significantly less likely to visit a specialist (ranging from OR = 0.71; 95% CI, 0.61-0.82; to OR = 0.88; 95% CI, 0.79-0.98) compared with white children. Black children in all age categories were significantly more likely to have filled any prescriptions for inhaled corticosteroids compared with white children (ranging from OR = 1.11; 95% CI, 1.02-1.21; to OR = 1.11; 95% CI, 1.04-1.19).

This is a good lesson for those who like to politicize science.  You can't lean Right or lean Left before the data comes in.  Minority children may still be at some disadvantage, but being uninsured isn't it.

There might be a biological answer, or a cultural answer, or even another economic answer that hasn't been explored.  Right thinkers will wait for it.

Doc D

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