Socioeconomic Status as it Affects the Treatment of

AsthmaPUBH 8135-5 Group Project by:

T. Fillingame, C. Floyd, M. Kessack,K. Trojak, & E. Uche

The Current Reality and Unacceptability of this Situation

by

Marti Kusack

The Current Reality

• Incidence of Asthma Rising Each Year• Current Cases of Childhood Asthma at

8% of the Population (Moorman, 2007)

• Compared with 3% of population in 1970• The number of cases in the lower

socioeconomic status is 10% of the population in the United States

• White population: 6.9% vs. Black population: 9.2%

Current Reality

• Mortality Rates for Asthmatic Children• 1979: 0.9 deaths per 100,000• 1998: 1.4 deaths per 100,000 (AMA, 2002)

• African-American Children 6 times more likely to die than white children

(Carlson & Stroebel, 2001)

Unacceptability of this Situation

• Asthma Lasts a Lifetime• Over 50% of children diagnosed with

Asthma will have it as an adult (Children’s Hospital

Boston, n.d.)

• Survey conducted in 2006:• Asthmatic Children Health Status 34%

ranked fair to good• Non-Asthmatic Children Health Status 10%

ranked fair to good (DOH, 2006)

Figure 2. Parent's description of child's health, by current asthma status, Washington State 2003

2%8%20%69% 10%24%35%31%0%

20%

40%

60%

80%

Excellent Very good Good Fair or poor

Per

cent

No Asthma

Asthma

Socioeconomic Status as it Affects the Treatment of Asthma

PUBH 8135-5 Group Project by:T. Fillingame, C. Floyd, M. Kessack,

K. Trojak, & E. Uche

Unacceptability of this Situation

• Large Urban Areas have Greater Numbers of Asthma Cases• Direct correlation between increased

auto traffic and numbers of Asthma (Jarrett,

2008)

• In-Home air pollution in these regions increase asthma attacks in these children

(McCormack, et al., 2008)

References

• AMA (American Medical Association). (2002). Response to Resolution 412. Retrieved from American Medical Association Web site: http://www.ama-assn.org/ama/pub/category/13547.html

• Carlson, J., & Stroebel, C. (2001). Childhood Asthma: A Growing American Epidemic. Retrieved from Population Reference Bureau Web site:

http://www.prb.org/Articles/2001/ChildhoodAsthmaAGrowingAmericanEpidemic.aspx

• Children’s Hospital Boston. (n.d.) My child has Asthma. Retrieved from Harvard Medical School Web site:

http://www.childrenshospital.org/az/Site2174/mainpageS2174P0.html

• DeWalt, D., Dilling, M., Rosenthal, M., & Pignone, M. (2007). Low Parental Literacy Associated with Worse Asthma Care Measures in Children. Ambulatory Pediatrics. 7(1): 25-31.

References• DOH (Department of Health). (2006). Asthma Among

Washington’s Children: A Report from the 2003 National Survey of Children’s Health. Retrieved from Department of Health Web site: http://www.doh.wa.gov/CFh/asthma/publications/asthma_children_update.doc

• Holgate, S., Boushey, H., & Fabbri, L. (1999). Difficult Asthma. London, UK: Martin Dunitz, Ltd.

• Jarrett, M., et al. (2008). Traffic-Related Air Pollution and Asthma Onset in Children: A Prospective Cohort Study with

Individual Exposure Measurement. Environmental Health Perspectives. 116(19): 1433-1438.

• McCormack, M., et al. (2008). In-home air pollution heightens asthma symptoms. Environmental Health Perspectives.

Doi:10.1289/ehp.11770.• Moorman, M., et al. (2007). National Surveillance for Asthma—

United States, 1980-2004. Morbidity and Mortality Weekly Report. 56(SS08): 1-14; 18-54.

Unacceptability of this Situation

• Socioeconomic Status and Asthma• Lower Socioeconomic children had more

hospital admissions and worse outcomes

• Less Asthma medications were dispensed in poorer areas (Holgate, Boushey, & Fabbri, 1999)

• Children from low literacy rate homes had more exacerbations of Asthma attacks – missed more school

(DeWalt, Dilling, Rosenthal, & Pignone, 2007)