ASTHMA

Asthma is a very important issue for me because both of my children has chronic asthma.  My son asthma is better controlled than my daughter's is.  I can expect my daughter to be hospitalized at least once or twice a year from asthma related sickness.  Because asthma is so severe my children have a list of medications that they should take daily.  I must say that the medication is VERY EXPENSIVE....My kids inhaler cost $195 a piece and that is the cheapest item from the list.

Asthma is the most common chronic health disorder in children, currently affecting one in seven – a historical high. Minority and low-income children are disproportionately affected by the disease, and the most likely to be hospitalized for its symptoms. In urban areas, over 80 percent of children struggle to keep their asthma under control; these children are more likely to sustain continuous exposure to dangerous environmental triggers, which can worsen their conditions.

Asthma is the most common chronic disease in childhood. Childhood asthma rates are at historically high levels: In 2008, one in seven children had been diagnosed with asthma at some point in their lives.

Minority and low-income* children are disproportionately affected by asthma. Compared with White children, Black children are more likely to have asthma, to visit the emergency room and to be hospitalized for asthma-related symptoms.

• Black children are approximately one and a half times more likely to ever have been diagnosed with asthma than White children.

• Black children are over four times more likely to seek care at an emergency room and three times more likely to be hospitalized for asthma than White children.
• Children in low-income families are more than twice as likely to ever have been diagnosed with asthma than children in families that are not low-income.
• Children living in inner cities face unique challenges. 85 percent of inner-city children with asthma have uncontrolled symptoms. These children have disproportionate exposure to allergens like dust mites and mold and local irritants such as secondhand smoke and air pollution, all of which are associated with development and worsening of asthma.

Many children with asthma do not get the regular care they need, leading to a lack of effective treatment and poor asthma control. Asthma’s effects depend greatly on whether a child receives regular checkups with education and follow-up treatment plans.

• Black children and Latino children receive about half as much outpatient care and medication management as White children. Moreover, Black children and Latino children are less likely to have a usual place of medical care than White children.

• One out of nine Black children is uninsured. More than one-fourth of uninsured Black children had to delay needed medical care and more than one-fifth of uninsured Black children did not get needed medical care because of cost.
• Routine medications for chronic asthma symptoms are often underprescribed and underused. Children with consistently poorly controlled asthma have a six-fold increased risk for hospitalization due to severe asthma symptoms.

Asthma, especially poorly controlled asthma, is a significant source of medical costs for families and for our country.
 

• The estimated annual cost for treating asthma in children is $8 billion.

• In 2006, children required nearly 150,000 hospitalizations and made 593,000 visits to emergency departments for asthma.

• Primary care doctor visits to help manage asthma cost much less than emergency room visits and hospitalizations. In Texas, the cost for a child to visit a doctor in the early stages of an asthma attack is about $100, but going to the emergency room to treat full-blown asthma symptoms can result in a three-day hospital stay costing more than $7,300.
• When children receive tailored asthma education and ongoing treatment, they are less likely to require costly hospitalizations and avoidable emergency room visits.

Poorly controlled asthma interferes with children’s daily activities and education, contributing to substantial indirect costs of asthma. Asthma symptoms can affect children’s ability to learn, play, and sleep well, and can prevent them from reaching their full potential.

• Asthma is one of the leading causes of school absenteeism. Asthma-related illnesses cause children to miss almost 13 million school days a year. Children with uncontrolled asthma consistently miss more school than children with well-managed asthma.

• Chronic absenteeism exacts a high price from children, who have difficulty making up the work they missed and keeping up with their peers, and from their parents, who must often take time off from work during these absences to care for their sick children. Parental loss of work contributes significant indirect costs to the nation each year in lost productivity.
• In one study, kindergarten children with asthma had significantly lower school readiness skills compared to children without asthma.
• Children with severe asthma have to repeat a grade almost three times more often than children with mild
asthma.

References
http://www.childrensdefense.org/policy-priorities/childrens-health/asthma/


ASTHMA IN LATIN AMERICA

 Asthma has emerged as an important public health problem in many Latin American countries over the past decade. In Brazil and Costa Rica, the prevalence of asthma and associated morbidity is as great or greater as reported in traditional high prevalence countries such as the US, but remains neglected as a public health priority. Asthma in Latin America is associated particularly with underprivileged populations living in cities but remains relatively rare in many rural populations. The causes of asthma in Latin America are likely to be associated with urbanization, migration, and the adoption of a modern ‘Westernized’ lifestyle and environmental changes that follow these processes that include changes in diet, physical activity, hygiene, and exposures to allergens, irritants, and outdoor and indoor pollutants. Because of the enormous social, genetic, and environmental contrasts within and between Latin American countries, and the large differences in prevalence associated with these differences, the investigation of asthma in Latin America provides important research opportunities to identify the social and biological mechanisms that underlie asthma development. Asthma in Latin America poses enormous challenges for health policy makers, health services, and researchers to respond to and alleviate the growing burden of asthma disability, particularly among marginalized urban populations.

http://onlinelibrary.wiley.com/doi/10.1111/j.1398-9995.2008.01902.x/full