6833 Impact of poverty and ethnicity on asthma symptoms and outcomes in children

Objectives The Children and Young People's Health Partnership model1 includes nurse-led early intervention care for children with asthma in a highly deprived and ethnically diverse community in South London. Children with asthma are invited to complete a biopsychosocial pre-assessment health check. Children with uncontrolled asthma or high health service use are triaged to the service. We aimed to investigate: 1) asthma severity by poverty and ethnic groups before proactive care 2) differences between groups regarding duration of care to achieve symptom control. Methods Our population included children with asthma aged 2-2 collected at the health check and each clinic visit. Uncontrolled asthma is an ACT score below 20. Deprivation (IDACI-2019) was by quintile, ethnicity was self-reported. Data was described using contingency tables and summary statistics. A random effects multivariable logistic model clustered at the individual child level investigated symptom control. Results Half (472/901) of all children receiving the service were from the most deprived quintile and 71% (636/901) were from non-White ethnic groups. Children from more deprived, or non-White ethnic groups had, on average, worse baseline asthma control and required more clinic appointments to achieve asthma control. The odds of good asthma symptom control was, overall, 44% lower in children in the most compared with the least deprived groups: OR:0.56 95%CI(0.37–0.86). The odds of good asthma symptom control was 46% lower among children of Black ethnicity, compared to White ethnicity, OR: 0.54 95%CI(0.40- 0.72). More than 80% children in the least deprived group achieved asthma control by the 3rd clinic visit while it took until the 4th clinic for 80% children in the most deprived group or of a Black ethnicity to achieve good control – Figure 1. Conclusion Children from areas of high deprivation or from a non-White ethnicity are more likely to have uncontrolled asthma, and take longer to achieve asthma control than those from lower levels of deprivation or a White ethnicity. The ethnicity and deprivation levels of the local children and young people population need to be taken into account when modelling the demand and capacity required to deliver proactive asthma services to this population. Population health methods have the potential to identify unmet needs and reduce inequalities in outcomes. References Wolfe I, Forman J, Cecil L, et al. Effect of the Children and Young People's Health Partnership model of paediatric integrated care on child health outcomes: a pragmatic two-arm cluster randomised controlled trial. Lancet Child and Adolescent Health. Published Online October 19, 2023 https://doi.org/10.1016/S2352-4642(23)00216-X. Juniper EF, Gruffydd-Jones K, Ward S, Svensson K. Asthma Control Questionnaire in children: validation, measurement properties, interpretation. Eur Respir J 2010;36:1410–16.