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The continuing problem of asthma in very young children: a community-based participatory research project
Belinda Wilburn Nelson1, Daniel Awad, Jeffrey Alexander
1Center for Managing Chronic Disease, University of Michigan, 109 Observatory, Ann Arbor, MI 48109, USA. belindan@umich.edu
Insights
Asthma significantly impacts low-income, urban African-American children. Many young children in Detroit Head Start programs have undiagnosed or untreated asthma, highlighting a need for improved care within this vulnerable population.
Area of Science:
- Pediatric Pulmonology
- Public Health
- Epidemiology
Background:
- Asthma disproportionately affects low-income minority children in urban settings.
- African-American children experience higher asthma rates, severity, and poorer outcomes.
- This study focuses on asthma prevalence in Detroit Head Start children aged 2-5.
Purpose of the Study:
- To determine the prevalence of asthma in young children attending Head Start programs in Detroit.
- To identify the proportion of children with undiagnosed or untreated asthma.
- To assess the current management and care of asthma in this vulnerable population.
Main Methods:
- Health screens distributed to caretakers of children in 6 Head Start agencies.
- In-depth phone interviews conducted with caretakers of children exhibiting asthma symptoms.
- Data collected from 3,254 children, with detailed baseline data from 675.
Main Results:
- 27% of children screened met criteria for probable asthma.
- Among those with persistent symptoms, 26% were undiagnosed and 21% untreated.
- Over half reported 3+ asthma episodes yearly; 36% lacked recent asthma-related healthcare visits.
Conclusions:
- Asthma is a significant issue in this population, particularly for African Americans.
- High rates of undiagnosed/untreated persistent asthma indicate gaps in care.
- Head Start programs can reach children with asthma but may require enhanced capacity to support families.
Background:
Asthma is a chronic health condition that has a disproportionate effect on low-income minority children who reside in large urban areas. African-American children report significantly higher rates than the general population of children and have more-severe asthma and poorer outcomes. This article describes the prevalence of asthma in a particularly vulnerable group: children aged 2-5 participating in Detroit Head Start programs.
Methods:
Health screens were distributed to caretakers of all children attending 6 Head Start agencies. Caretakers of children identified with active asthma symptoms were asked to complete an in-depth phone interview regarding their child's asthma.
Results:
Data collected from 3,254 children (78% African American) revealed that 27% met criteria for probable asthma. Of those with persistent symptoms, 26% were undiagnosed, and 21% were untreated. Baseline data (n = 675) showed that 95% had a regular doctor, but 36% had had no health care visit for asthma in the previous year. Of children with a history of asthma episodes, more than half reported 3 or more episodes in the preceding year. Forty-three percent of caretakers had discussed their child's asthma with Head Start, and 31% had an asthma action plan on file with Head Start.
Conclusions:
Asthma remains a significant problem in this population, especially for African Americans, as evidenced by high levels of undiagnosed children with persistent symptoms and questions regarding the care they receive. Head Start is a way to reach young children with asthma, but may need help to develop the capacity to assist families.
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