Why are Polynesian children admitted to hospital for asthma more frequently than European children?

Abstract

Polynesian children have higher hospital admission rates than European children. This study compared 156 Polynesian children with 199 European children admitted to hospital for asthma. After controlling for socioeconomic status Polynesian children were similar to European children for many variables, but there were a number of important differences. The number of previous hospital admissions for asthma was higher in Polynesians than Europeans (mean (SD), 3.9 (4.6) v 2.8 (3.8) respectively p = 0.028). Despite this, 33% of Polynesian children were not receiving any asthma drugs in the 24 hours prior to admission to hospital compared with 14% of Europeans (relative risk (RR) = 1.94, 95% confidence interval (CI) = 1.25-3.00) and fewer were taking sympathomimetics and cromoglycate. A similar trend in asthma drug usage was seen six months later. Polynesian children were less likely to be referred to hospital by a general practitioner than European children (42% v 64% respectively, RR = 0.72 95% CI = 0.58-0.89). The differences in hospital admission rates are not explained by genetic or socioeconomic factors but seem to be related more to patterns of medical management.