Asthma among homeless children: undercounting and undertreating the underserved

Area of Science:

• Pediatric Asthma Epidemiology
• Public Health
• Urban Health Disparities

Background:

• High asthma rates are observed in underserved children, including those of color, from urban medically underserved communities, and with limited economic resources.
• Identifying high-risk subgroups is critical for understanding the childhood asthma epidemic and developing effective interventions.

Purpose of the Study:

• To determine the population prevalence of asthma among homeless children.
• To assess asthma severity and treatment patterns in this vulnerable population.

Main Methods:

• A cross-sectional study was conducted in three family shelters in New York City.
• Data were collected from 740 children regarding prior physician diagnosis, current symptoms (National Asthma Education and Prevention Program criteria), medications, and emergency department visits.
• Prevalence was calculated based on physician diagnosis and reported symptoms.

Main Results:

• A prior physician diagnosis of asthma was reported by 26.9% of children.
• An additional 12.9% of children without a prior diagnosis reported symptoms consistent with moderate to severe persistent asthma.
• Overall asthma prevalence was estimated at 39.8%. Children with severe persistent asthma had high rates of emergency department visits (48.6%).

Conclusions:

• The prevalence of asthma among homeless children in New York City is approximately 39.8%, over six times the national average.
• Asthma in this population is likely severe and significantly undertreated, with limited use of anti-inflammatory medications.
• Findings highlight the urgent need for targeted asthma interventions for homeless children.