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Risk Factors & Triggers

Background

2014. IMPACT DC [Electronic Image] http://www.childrensnational.org/impactdc/

-Risk Factors:

-Genetic predisposition

-Exposure to environmental allergens including outdoor air pollution

-Triggers:

-Dust mites, cockroaches, pets, & molds

-Second hand tobacco smoke (poor children are more like to be exposed)

-Chronic disease

- Prevalence is at historically

high levels

-Causes significant

morbidity

-Major reason for ED visits & hospitalizations

AAAAI / Francisco Q. 2014. http://www.who.int/respiratory/asthma/burden/en/

Significant Asthma Study

References

National Center for Health Statistics (US. (2012). Health, United States, 2011: with special feature on socioeconomic status and health.

Ungar, W. J., Paterson, J. M., Gomes, T., Bikangaga, P., Gold, M., To, T., & Kozyrskyj, A. L. (2011). Relationship of asthma management, socioeconomic status, and medication insurance characteristics to exacerbation frequency in children with asthma. Annals of Allergy, Asthma & Immunology, 106(1), 17-23.

-Asthma management

-Socioeconomic Status

-Medication insurance characteristics

VS.

-Exacerbation frequency in children with asthma

Methods

Results

-Retrospective cohort study

-490 asthmatic children --> Complete data

-Demographics

-SES

-Drug plan characteristics

-Health status

-Health Resource use

-Symptoms

-Interview and administrative data on asthma ED visits and hospitalizations (1 year)

Conclusion

-Younger age, previous emergency visits, nebulizer use, pet ownership, and receipt of asthma education but not an action plan associated with more frequent exacerbations.

-Children with high income adequacy: 28% fewer exacerbations

-Family with drug insurance: girls 26% fewer exacerbations than boys

-Annual income deductibles greater than $90: 95% fewer exacerbations

-%Increase spent out of pocket on asthma meds-14% increase in exacerbations

Current Asthma Morbidity Among Children

Objective

-Identify factors associated with asthma exacerbation causing ED visits or hospitalizations related to:

-Health Status

-Socioeconomic status

-Drug insurance

-Socioeconomic status & health insurance related to control of symptoms

-Families with less comprehensive prescription drug coverage (and higher out-of-pocket costs) are less likely to purchase asthma maintenance drugs.

-In 2009–2010, asthma prevalence was higher for

children living in poverty than for those with higher

relative family income

-Exception: Hispanic children

CDC Health, United States 2011, with Special Feature on Socioeconomic Status and Health

Sophie Docker-Southamptom. (2011). Child with asthma [electronic image]. Retrieved from: http://www.futurity.org/more-to-asthma-than-inflammation/

**In 2009–2010, current asthma prevalence was lowest for children living at 200% or more of poverty, higher for children

in families at 100%–199% poverty, and highest for children living in poverty.

Socioeconomic Status & Asthma in Children

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