A national study of asthma in childhood.

Peckham, Catherine; Butler, N. R.

doi:10.1136/jech.32.2.79

Cited by 133 publications

(50 citation statements)

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“…Asthma has been thought to be an exception to the general trend of increased disease in the poor, being regarded as a disease of higher social classes, and a number of studies have supported this view [6][7][8][9]. Other reports have shown no association between the prevalence of asthma and socioeconomic status [10][11][12][13][14].…”

mentioning

confidence: 87%

“…Hospital admission rates depend on the prevalence of the disease, the severity of the disease in those who have it, and their medical care. Community surveys in Britain have not shown any increased prevalence of asthma in people of poorer socioeconomic status [6][7][8][9][10][11][12][13][14]. The increased hospital admission rate may, therefore, be due to increased severity of asthma, differences in the medical care received by asthma patients, or a combination of these factors.…”

Section: Discussionmentioning

confidence: 99%

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The relationship between asthma admission rates, routes of admission, and socioeconomic deprivation

Watson¹,

Cowen²,

Lewis³

1996

Eur Respir J

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T Th he e r re el la at ti io on ns sh hi ip p b be et tw we ee en n a as st th hm ma a a ad dm mi is ss si io on n r ra at te es s, , r ro ou ut te es s o of f a ad dm mi is ss si io on n, , a an nd d s so oc ci io oe ec co on no om mi ic c d de ep pr ri iv va at ti io on n ABSTRACT: This study aimed to explore the relationship between hospital admissions for asthma and socioeconomic deprivation. A retrospective study examined one year of hospital admissions for asthma in the West Midlands region of England (n=10,044), and in one of the region's wealthier districts, Worcester (n=251). Age standardized admission ratios (SARs) for asthma, and the routes of hospital admission, were compared with the Townsend Deprivation Index for the place of residence.Asthma SAR was strongly associated with deprivation as measured by the Townsend Index for the district of residence (Spearman rank correlation coefficient ρ=0.65; p=0.004). Asthma admission rates for all age groups, except those aged over 65 yrs, were higher in poorer districts. A significantly greater proportion of emergency admissions in poorer districts came via Accident and Emergency departments, rather than general practitioner referrals (ρ=0.76; p<0.001). Within Worcester District, SAR was associated with Townsend Index for the ward of residence (ρ=0.39; p<0.001). This remained significant after excluding repeat admissions (ρ=0.45; p<0.001).We conclude that asthma admissions are strongly associated with deprivation in the community. Differences in the health care received during acute exacerbations by asthma patients from different economic backgrounds is likely to be an important factor in this relationship.

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mentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

The relationship between asthma admission rates, routes of admission, and socioeconomic deprivation

Watson¹,

Cowen²,

Lewis³

1996

Eur Respir J

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“…Associations ofAW with both ofthese symptoms have been observed in prevalence surveys.23 24 Understanding the significance of these associations might throw new light on the mechanism of asthma.…”

Section: Surveysinwhichallwheezingillnesswasincluded2 10-12mentioning

confidence: 97%

The natural history of asthma in childhood.

Anderson¹,

Bland²,

Patel³

et al. 1986

Journal of Epidemiology & Community Health

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138

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SUMMARY The incidence and prognosis ofchildhood asthma and wheezing illness (AW) was studied using data obtained at ages 7, 11, and 16 from a national cohort of 8806 children born in 1958. By the age of 16, 24-7% were reported to have experienced at least one episode of AW. In 18-3% AW had started before the age of 8, but only 4-2% continued to have symptoms in later childhood. A further 3-6% began to have AW between the ages of 8 and 11, and 2-8% began between the ages of 12 and 16. Ofthose with AW at age 7, 28 3% had symptoms at 11 and 16 5% at 16; these proportions were about doubled if AW at 7 had been severe. The associations between natural history and a large number of perinatal, social, environmental, and medical factors were examined. Those which predicted the onset of AW after the age of 7 were: male sex ofchild; mother aged 15-19 at child's birth; history of pneumonia, whooping cough, throat or ear infections or tonsillectomy; eczema, allergic rhinitis; and periodic vomiting or abdominal pain.To understand the natural history of asthma, a description of both its incidence and prognosis is required. Prevalence rates obtained by cross-sectional population studies reflect only the net effect of incidence and prognosis, and those relying on retrospective assessments have the additional problem ofinadequate and selective recall. With one exception' previously reported cohort studies have been essentially follow up studies designed only to study prognosis since only subjects with asthma were seen subsequently.2-5The National Child Development Study,6 which originated in the National Perinatal Study,7 has followed up at ages 7, 11, and 16 nearly every child in England, Scotland, and Wales born in one week of March 1958. Data, which were collected by parent interview and physical examination of the child, comprised a wide variety of perinatal, medical, social, behavioural, and educational variables. Since the study was not designed to investigate the natural history of asthma there were, not unexpectedly, shortcomings in the assessment of both asthma and the range of aetiological factors. Nevertheless the size and representativeness of this national cohort offer a unique opportunity to examine the natural history of asthma and wheezing illness. MethodsInformation about current and past asthma or wheezing was obtained as part of a structured questionnaire on medical and other topics administered to parents by health visitors. Data for all three interviews (at ages 7, 1 1, and 16) were obtained for 8806 of the original cohort of 17419 births comprising the 1958 Births Survey (98% ofall births in that week). Most ofthe analysis in this paper relates to the 8806 children with complete data, but, as we shall show, there was no evidence of a difference in asthma and wheeze between these children and those for whom data were incomplete.The form of the questions on asthma or wheezing differed at each age. At age 7, parents were asked whether their child had ever had "attacks of asthma," and the same question was repe...

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“…Early studies in Britain and more recent studies in Singapore and Southern China/ Hong Kong found the prevalence of parent-reported asthma or wheezing to be greater among subjects of higher socioeconomic status [1][2][3][4]. Studies in the USA have tended to find the reverse, i.e.…”

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confidence: 97%

Socioeconomic deprivation and asthma prevalence and severity in young adolescents

Poyser¹,

Nelson²,

Ehrlich³

et al. 2002

European Respiratory Journal

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This study used the international study of asthma and allergies in childhood (ISAAC) to investigate the association between asthma and socioeconomic deprivation among young adolescents in Cape Town, South Africa.The completed ISAAC written and video questionnaires of 4,706 13-14-yr-old school pupils were used. The prevalence of asthma symptoms was analysed by a local index of socioeconomic deprivation, based on residential location and defined on a 10-category scale from least to most deprived. Linear trends were examined visually and the prevalence odds ratio was used to summarize overall trends.In general, the least socioeconomically deprived pupils reported higher prevalences of asthma symptoms "ever" and "in the last 12 months". In contrast, the most socioeconomically deprived pupils reported higher asthma-symptom occurrence monthly or more frequently in the previous 12 months. A subgroup of pupils from low-income areas commuting to better-off schools showed the highest symptom prevalences.The findings are consistent with a model in which an increase in the incidence of asthma is driven by factors associated with improved social circumstances, whereas severity is determined by factors associated with poverty. The impact of social mobility on asthma, including reporting of symptoms, deserves closer study.

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A national study of asthma in childhood.

Cited by 133 publications

References 11 publications

The relationship between asthma admission rates, routes of admission, and socioeconomic deprivation

The relationship between asthma admission rates, routes of admission, and socioeconomic deprivation

The natural history of asthma in childhood.

Socioeconomic deprivation and asthma prevalence and severity in young adolescents

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