Homeless children have high rates of asthma

March 01, 2004

CHICAGO - The prevalence of asthma among homeless children in New York City is approximately 40 percent, which is six times the national rate for children, according to an article in the March issue of The Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

"In the United States, children of color, children who live in urban medically underserved communities, and children whose families have limited economic resources have excessively high rates of asthma," according to background information in the article. Identifying high-risk groups of children is important in the development of successful interventions, the article states.

Diane E. McLean, M.D., Ph.D., M.P.H., from Columbia University and the New York State Psychiatric Institute, New York, and colleagues at the Children's Health Fund and Columbia's Mailman School of Public Health investigated the prevalence of asthma among 740 children whose families entered three New York City family shelters between June 30, 1998 and September 18, 1999.

"Of the children, 26.9 percent had a prior physician diagnosis of asthma. In addition, 12.9 percent of the children without a prior physician diagnosis of asthma reported symptoms consistent with moderate or severe persistent asthma," the authors write. They also found that few of the children with persistent asthma received anti-inflammatory treatment.

The authors state that "High levels of exposure to adverse psychological factors may play a critical role in determining the high levels of severity and undertreatment found among homeless children."

"We estimate the prevalence of asthma among a random sample of homeless children in NYC is likely to be at least 39.8 percent - more than six times the national rate for children," write the researchers. "Asthma in homeless children is also likely to be severe and substantially under-treated."
(Arch Pediatr Adolesc Med. 2004;158:244-249. Available post-embargo at archpediatrics.com)

Editor's Note: This study was supported by the Children's Health Fund, New York, N.Y., and by an unrestricted educational grant from Schering-Plough, Kenilworth, N.J.

For more information, contact JAMA/Archives Media Relations at 312/464-JAMA (5262) or e-mail mediarelations@jama-archives.org.

To contact corresponding author Irwin Redlener, M.D., call Randee Sacks at 212/305-8044.

The JAMA Network Journals

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