Why This Matters

Asthma affects nearly 5 million children in the United States and is more prevalent among children with Medicaid health insurance coverage than those with private health insurance and among Black, non-Hispanic (hereafter, Black) children than white, non-Hispanic (hereafter, white) children. Recent evidence shows there are considerable Black-white racial disparities in the occurrence of asthma-related hospitalizations and emergency department (ED) visits among Medicaid-enrolled children. Differences in receipt of prescription medications to control asthma symptoms may contribute to these racial disparities.

What We Found

In this analysis, we assess differences by race in receipt of recommended asthma medications among Medicaid-enrolled children. We examine a large population of Medicaid-enrolled children with persistent asthma across 11 states, using modernized Medicaid claims and encounter data from the Transformed Medicaid Statistical Information System. We examine whether Black enrollees were more or less likely than white enrollees to receive recommended asthma medications in 2019, and we assess the extent to which differences in receipt of recommended medications explained the Black-white racial disparity in asthma hospitalizations and ED visits.

Among the nearly 200,000 Medicaid-enrolled children with persistent asthma in our sample, we find the following:

• Only 43.1 percent received the recommended asthma prescription medications in 2019.
• Adjusting for other sociodemographic and enrollment characteristics, Black enrollees were 9.1 percentage points less likely than white enrollees to receive the recommended asthma prescription medications (p <0.001).
• Receiving the recommended asthma prescription medications decreased the probability of a subsequent asthma hospitalization or ED visit by 1.4 percentage points (p <0.001).
• Black enrollees were 3.1 percentage points more likely than white enrollees to have an asthma hospitalization or ED visit, even after controlling for receipt of recommended prescription medications (p <0.001).