For Immediate Release
Contact: Jim Augustine 415-905-1744
After May 27: Elizabeth Hlinko 212-315-6473
NEW STUDIES SUGGEST ROLE OF VIOLENCE IN ASTHMA
AND HIGHER THAN EXPECTED ASTHMA RATES IN INNER CITY
Education Shows Promise in Reducing Dangerous Impact of Asthma
SAN FRANCISCO, May 19--Minority children in the inner city suffer
disproportionately from asthma, and exposure to violence may play a role,
suggest new research presented at the American Lung Association/American
Thoracic Society International Conference. Educational interventions,
however, show promise in reducing the dangerous impact of asthma,
according to studies presented here.
Asthma rates among minority populations are much higher than among
the general population, according to Dr. Kevin Gibson of the University of
Pittsburgh. "We're seeing an increase in the rate of prevalence of asthma
among minority populations, and higher hospital utilization rates," Dr.
Gibson said.
In 1994, there were an estimated 1.9 million cases of asthma among
African Americans. Although African Americans represent only 12.5 percent
of the population, 22 percent of all asthma deaths occur in the
African-American community.
One study presented at the ALA/ATS International Conference suggests that
exposure to violence may be associated with increased severity and
occurrence of asthma among inner-city children.
The preliminary data from the study by Dr. Rosalind Wright of Brigham and
Women's Hospital in Boston suggests that children exposed to violence in
their neighborhood (such as hearing gunshots, or witnessing physical
violence, often involving weapons), were twice as likely to experience
wheezing and to use bronchodilator asthma medication for wheezing, and
almost three times as likely to be diagnosed with asthma compared with
children not exposed to violence. The study found that 25% of the children
enrolled thought they would be hurt by violence.
"The burden of the rising incidence of asthma is borne by the inner-city
population, and we don't really know why that is," Dr. Wright said. "Some
factors, such as cockroach exposure, or lack of access to health care,
provide part of the answer, but they don't entirely explain the rise.
Researchers have been studying the psychological impact of violence on
children, but we also need to be looking at the impact of violence on
physical disease," she said.
A second study presented at the conference concludes that the prevalence and severity of asthma among inner-city middle-school children may be much higher than what is currently reported. Dr. Salvatore Mangione of Allegheny University Hospitals in Philadelphia surveyed 1,007 school children from two predominantly Hispanic and African-American middle schools in Philadelphia. He found that almost half said they had had at least one of five asthma symptoms in their life such as coughing or wheezing, 36.3% reported having experienced at least one symptoms in the last 12 months, and 28.8% one or more times a month.
Only 39.4% of all the children with these symptoms were aware they may
have had the disease. Only 10% of all the children with asthma had been
identified by the school staff; these children had significantly worse
asthma and also were absent more often.
"The message here is that by not screening children for asthma, we have a
missed opportunity," Dr. Mangione said. "Asthma is a lifelong disease, and
asthma education skills learned early on can have a major impact. Patient
education is essential for reducing the burden of asthma."
Another study found that a neighborhood asthma education program reduced
the need for emergency treatment for asthma in St. Louis. Dr. Edwin Fisher
of Washington University in St. Louis and colleagues studied the
Neighborhood Asthma Coalition, a community group that provided educational
programs for parents and children, promotional activities, and
individualized support and education by trained neighborhood residents.
African-American children ages 5 to 14 who were rushed to the emergency
room or hospitalized for asthma at least once within the prior year were
enrolled in the study. Parents of children who took part in the
coalition's activities reporter greater improvements than children not
participating in deciding to get help when medication didn't work,
appropriate medication use and discouraging smoking near the child.
Children with high levels of participation in the program (such as
attending six or more program classes or events) reported an approximately
80% reduction in incidents of ER visits or hospitalization compared with
low participation or children not participating.
Parents in the study were asked to indicate which symptoms would make them
decide to get help for their child with asthma. Before the study, 30% of
parents participating in the program said they would get help when
medication doesn't work; after participating in the study, 53% gave this
answer.
"We think the study shows promising signs that we can make a positive
impact on attitudes toward asthma and its care in a traditionally
hard-to-reach group," Dr. Fisher said.
"The purpose of the program is to engage the whole neighborhood in a
better understanding of asthma. That way, if a mother doesn't understand
that her child with asthma needs emergency treatment, maybe the child's
grandmother or mother will. In this way, we can save lives," Dr. Fisher
said.
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