Socio-economic inequalities affect asthma hospitalization rates for kids

Asthma hospitalization rates for Canadians younger than 20 have declined by 50% over the past 10 years. Yet asthma continues to be one of the leading causes of hospital stays among children and youth.

One of CIHI’s new reports — Asthma Hospitalizations Among Children and Youth in Canada: Trends and Inequalities — looks at socio-economic inequalities in asthma hospitalizations.

How do income and education affect asthma hospitalizations?

We worked with Statistics Canada to apply newly developed equity stratifier definitions (PDF) to CIHI and Statistics Canada data to uncover which populations are experiencing higher asthma hospitalization rates than others.

This analysis revealed that children and youth living in lower income neighbourhoods, as well as those living in households with lower educational attainment, were admitted to hospital more frequently.

Over the past 10 years, asthma hospitalization rates remained about 1.5 times higher in the lowest-income neighbourhoods compared with the highest-income neighbourhoods.

When it comes to education level, hospitalization rates were about double for children and youth living in households in which the highest level of education was less than high school, compared with those living in households in which it was a master’s degree or doctorate. This inequality was more pronounced for boys than for girls.

Text version of infographic

Asthma hospitalization (age 0 to 19) by province/territory, 2006–2007 to 2008–2009 versus 2013–2014 to 2015–2016

Province/territory	Hospitalization rate per 100,000 population: 2006–2007 to 2008–2009	Lower 95% confidence limit: 2006–2007 to 2008–2009	Upper 95% confidence limit: 2006–2007 to 2008–2009	Hospitalization rate per 100,000 population: 2013–2014 to 2015–2016	Lower 95% confidence limit: 2013–2014 to 2015–2016	Upper 95% confidence limit: 2013–2014 to 2015–2016
Source Hospital Morbidity Database, Canadian Institute for Health Information. Copyright 2018 Canadian Institute for Health Information
Newfoundland and Labrador	171	157	186	85	75	96
Prince Edward Island	226	195	257	163	137	189
Nova Scotia	193	182	205	80	72	87
New Brunswick	184	172	196	65	58	73
Quebec	172	168	175	66	64	68
Ontario	125	123	128	90	88	92
Manitoba	108	101	114	61	56	66
Saskatchewan	169	160	178	110	103	117
Alberta	105	101	109	72	69	75
British Columbia	105	101	109	71	68	74
Yukon	96	57	135	30	9	50
Northwest Territories	153	115	191	121	86	157
Nunavut	83	56	111	78	53	103
Canada	135	134	137	79	78	80

Applying the lessons

The causes and treatment of asthma are complex. According to the literature, there are several possible reasons for the differences in asthma hospitalizations.

For example, lower income and education are associated with risk factors for developing asthma and triggering an asthma attack, such as smoking and poor housing quality. Effective asthma management also has many components, including adhering to medications that can be costly, avoiding asthma triggers and implementing an asthma action plan.

“The decline in asthma hospitalizations over the past decade suggests that kids and parents are getting more of the support they need to manage their conditions. Yet there is still room for improvement to further reduce the extreme asthma events that necessitate a hospital stay,” said Kathleen Morris, vice president of Research and Analysis at CIHI.

Health care decision-makers can use this updated information to identify where they can improve their health systems and health outcomes for Canadians.

Health inequalities go beyond asthma hospitalizations

This is just the latest example of our work on health equity and population health in Canada. Explore our suite of reports and interactive tools to shed further light on this issue.