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Racial and Ethnic Disparities in the Quality of Asthma Care^*

^* From the Institute for Health Policy Studies (Dr. Cabana), Department of Pediatrics, Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA; UCLA/RAND Program on Latino Children with Asthma (Dr. Lara), UCLA Department of Pediatrics and RAND Health, Los Angeles, CA; and Department of Medicine (Dr. Shannon), Cook County Hospital, Chicago, IL.

Correspondence to: Michael D. Cabana, MD, MPH, Division of General Pediatrics, University of California, San Francisco, 3333 California St, Suite 245, San Francisco, CA 94118; e-mail: michael.cabana{at}ucsf.edu

Racial and ethnic disparities in the quality of asthma care have been well documented in the United States. There are multiple factors associated with such disparities in asthma care, including structural barriers (eg, ability to access the health-care system), process-of-care barriers (eg, ability to navigate the health-care system), and process-of-care barriers at the interpersonal level (eg, ability to work effectively with a health-care provider) for equitable, quality asthma care. This article summarizes these issues and identifies specific areas for future investigation. At a health-systems level, further work is needed to understand how medical care financing arrangements may or may not be contributing to racial and ethnic disparities in asthma care, as well as how specific organizational initiatives can address these issues. Research needs at the patient/provider level include defining the content and methods for disseminating issues regarding cultural competency to health-care providers.

Key Words: asthma • emergency department • ethnicity • health care • quality of health care • race

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