Social deprivation and asthma

Abstract

This study was conducted to see whether children living in socially deprived areas were more likely than other children to be admitted to hospital for asthma, and, if so, whether their excess risk was attributable to a higher prevalence of asthma or poorer treatment. Hospital admission rates for asthma were obtained for Cardiff electoral wards and compared with the Townsend indices of deprivation. A survey of respiratory symptoms was conducted in schoolchildren; prevalence of symptoms was compared with Townsend index and asthma admission rate for the schools' catchment areas. Asthma admissions were strongly correlated with Townsend indices at all ages. The prevalence of reported asthma and various degrees of wheeze in the schools was not significantly correlated with Townsend index or hospital admission rate in the corresponding areas. The presence of a smoker in the house was strongly associated with Townsend index and admission rate; children whose houses contained a smoker were more likely than others to have wheezed in the past year and to have disturbed nights due to wheezing. There was a non-significant negative association between Townsend index and regular use of inhaled steroids. The relationship between hospital admission for asthma and social deprivation is not explained by variations in prevalence, but it may be attributable to the aggravation of symptoms by active or passive smoking, and perhaps also to differences in management.

Relationship of asthma management, socioeconomic status, and medication insurance characteristics to exacerbation frequency in children with asthma

“…These findings support previous research demonstrating the significant impact of age, sex, disease severity, and SES on asthma morbidity. 9,23,24 Although evidence of the effectiveness of asthma action plans is mixed, 10,11,25,26 the study found that children with action plans had fewer subsequent exacerbations. The study further revealed the adverse effects of medication cost-sharing on health outcomes in children.…”

Clinical management of asthma in 1999: the Asthma Insights and Reality in Europe (AIRE) study

“…Both sampling frames would tend to exclude subjects from poorer and more rural areas. Previous research in the USA [22±25] and Europe [26] indicates that lower socioeconomic status may reduce access to asthma-related medical care and increase the risk of asthma morbidity. Given the very low proportion of potential subjects with a mobile phone but no household landline, and the high likelihood that these people would be young adults, it is unlikely that the lack of phones among these individuals was a strong influence on the results of the study.…”

Asma em escolares do Recife - comparação de prevalências: 1994-95 e 2002

“…23 For epidemiological purposes, exercise challenge tests are questionable for the diagnosis of exercise-induced asthma. 35 Comparing the responses to the ISAAC questionnaires with bronchial hyperresponsivity from exercise, Ponsonby et al 36 found that, in Tasmanian children, sensitivity and specificity were 60 and 77%, respectively, and concluded that the questionnaire was accurate. In the current study this variable also altered differently from reported asthma.…”