Racial, Ethnic, and Socioeconomic Disparities in Childhood Asthma Recovery in the United States

Abstract

Objective: To examine racial, ethnic, and socioeconomic disparities in asthma prevalence and recovery among United States children, using nationally representative data.

Study design: We conducted a cross-sectional analysis of pooled data from the 2016 to 2022 National Survey of Children's Health. Multivariable logistic regression was used to estimate adjusted odds ratios (aORs) for current asthma and recovery. Complex sampling weights were applied for national estimates.

Results: The sample included 277 215 children aged 0-17 years. Nationally 7.4% had a current asthma diagnosis, and 34.7% of those with a lifetime asthma diagnosis were classified as recovered. Non-Hispanic Black children had significantly higher odds of current asthma (aOR 2.03; 95% CI, 1.83-2.25) and lower odds of recovery (aOR 0.66; 95% CI, 0.56-0.79) compared with non-Hispanic White children. Hispanic children had moderately higher asthma prevalence (aOR 1.39; 95% CI, 1.24-1.55) but recovery odds that were statistically comparable with non-Hispanic White children (aOR 1.03; 95% CI, 0.87-1.22). Children from immigrant families had lower asthma prevalence (aOR 0.64; 95% CI, 0.57-0.72) and higher odds of recovery (aOR 1.50; 95% CI, 1.26-1.78). Socioeconomic disparities were also prominent: children living below the federal poverty level and those experiencing financial hardship were more likely to have current asthma and less likely to recover than their higher income peers.

Conclusions: Significant disparities in pediatric asthma extend beyond diagnosis to recovery, disproportionately affecting Black, low-income, and socioeconomically disadvantaged children. These findings underscore the need for equity-focused strategies to support long-term asthma management and recovery in pediatric populations.

Keywords: National Survey of Children's Health; childhood asthma recovery; health equity; racial and ethnic disparities; social determinants of health; socioeconomic status.