Asthma Prevalence: A New Study Challenges

Conventional Wisdom
Race, ethnicity, and poverty increased the risk of asthma
more than urban residence.
Photo by M. Greenlar /

of the disease are high, according

to the Centers for Disease Control
and Prevention. The disease, char
acterized by inflammation and
obstruction of the airway and ex
accerbations, or attacks, brought
on by allergy-related or environ
mental triggers, currently affects
roughly 25 million people in the
United States. For many years it
has been known that people living
in the inner city are disproportion
ately affected by asthmaand it
has been widely accepted that the
urban environment itself was the
greatest contributing risk factor.
However, a new study from the
Johns Hopkins Childrens Center
reveals that other factors, such as
race, ethnicity, and poverty, may
increase the risk of asthma more
than residence in an urban loca
tion.
Recognizing the limited amount
of research regarding asthma prev
alence in the inner city and the need
for up-to-date evidence to guide
public health efforts to man age the
disease, researchers exam ined the
prevalence of and risk

factors for asthma in children liv

ing in urban environments and
those living outside of the inner
city. They gathered data from the
National Health Interview Survey
(20092011) and the 2000 U.S.
Census, classifying residential lo
cations into four groups: large
metro, central; large metro,
fringe, implying suburban; me
dium metro; and small metro
rural areas. The study population
ajn@wolterskluwer.com

Syrac use Newspapers / The Image Works .

he prevalence of asthma in the

United States has in creased in recent
years, and the health and economic
burdens

included 23,065 children, ages

six to 17 years, from 5,853 cen
sus tracts.
They found that the prevalence
of asthma was 12.9% among chil
dren in the inner city and 10.6%
outside of the inner city, but when
race, ethnicity, region, age, income
level, and sex were factored in, the
results were no longer significant.
Results showed black race, Puerto
Rican ethnicity, and lower house
hold income to be strong inde
pendent risk factors for asthma

exacerbation and [ED] visits for

asthma.
The study authors acknowl edge
that its difficult to distinguish
environmental from genetic risk
factors, as well as the need for ad
ditional research into factors in
fluencing asthma prevalence to
improve health outcomes in those
most at risk.Maria Nix, MSN,

RN
Keet CA, et al. J Allergy Clin Immunol 2014
Jan 7 [Epub ahead of print].

NewsCAP
Questions arise over strict bed rest when concussions occur in teens. Resting for

five days is no better than the typically recommended two days for teens who incur a mild
concussion, finds a study in the February Pediatrics, the first known trial to com-pare rest
strategies in pediatric patients. In fact, teens told to rest for five days reported more
physical symptoms early and more emotional symptoms throughout the study. The 99
patients, ages 12 to 15 years, were randomly assigned to the two groups. Those in the
five -day group could not attend school. Missing school and falling behind aca-demically
may contribute to depression and physical and emotional symptoms. Strict rest for five
days offers no benefit over current usual care, conclude the authors.

AJN

17

April 2015

Vol. 115, No. 4