Andy's Article 3

[Article 3] Michelle M. Cloutier, Dorothy B. Wakefield, Charles B. Hall and Howard L. Bailit. Childhood Asthma in an Urban Community: Prevalence, Care System, and Treatment Chest 2002;122;1571-1579

Cloutier, et al, attempt to describe the system of asthma treatment in an urban minority community. The authors indicate several Community factors and personal health behaviors that are associated with asthma prevalence and morbidity. These include low socioeconomic status, environmental tobacco smoke exposure, poorly maintained housing, and indoor and outdoor allergens, including cockroach and rodent infestation.

Asthma prevalence and severity were estimated from surveys of children seeking medical care in local (Hartford, CT) clinics. Asthma severity was based on the frequency of daytime and nocturnal symptoms, the degree of exercise impairment, the frequency of as-needed inhaled bronchodilator therapy, and the effect of symptoms on lifestyle and school attendance.

Additionally, the authors describe differences in health-care delivery factors that may substantially impact outcomes. These include inadequate availability and access to health care, and language and cultural barriers. Furthermore, major provider problems include the failure to diagnose asthma and the under-prescribing of inhaled and oral corticosteroid therapy.

[Andy’s summary and opinions: These authors confirm findings from previous articles- namely, that Asthma is the most common chronic disease of children in the U.S. and the risk factors associated with chronic asthma. Again, and this is conceded by the authors, these findings can only be applied to those seeking medical care, not the whole child population.]