- Eggleston PA,
- Malveaux FJ,
- Butz AM,
- et al.
Purpose of the Study
It is well recognized that asthma morbidity is disproportionately high in inner-city children. The purpose of the study was to examine medication use of children in an urban environment and to relate this use to other social and medical variables.
Patients and their families recruited from elementary schools in Baltimore and Washington, DC.
A total of 508 children with asthma were identified by school health records and teacher surveys, and questionnaires were completed by 392 families.
In general, children were undermedicated. A total of 78 children (20%) reported no medication or over-the-counter medication use, although 37% reported asthma severe enough to be associated at least 20 days of school missed per year, and 37% had a visit to the emergency room in the past 6 months. Theophylline was the most commonly used daily medication, and only 11% took some form of daily antiinflammatory medication (cromolyn or inhaled corticosteroids). Supervision was also lacking, as more than half of children ages 9 years and older were responsible for their own medication.
The authors concluded that poor children with asthma living in urban areas tend to be undermedicated, particularly in terms of antiinflammatory medication.
Although the root cause for the increased amount of asthma in inner-city children remains obscure, this report and previous studies suggest that the increased asthma morbidity in this environment is attributable to problems with health care access and supervision. This suggests that well-targeted public health efforts are likely to make a difference in lives of children with asthma in an urban environment, and the same principles are likely to apply to poor children with asthma in nonurban environments (see McGill KA et al,Pediatrics 1998;102:77–83).