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02-02-2010 | Respiratory | Article

Asthma morbidity high among US children in rural areas


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MedWire News: Asthma prevalence is similar among children living in inner-city and rural areas of the USA, but children from rural areas have significantly greater levels of asthma-related morbidity, researchers have found.

“These findings suggest that not all rural environments are protective against atopic disorders such as asthma, and warrant further investigation of the impact of environmental and sociodemographic factors on high-risk rural children,” comment Tamara Perry (University of Arkansas for Medical Sciences, Little Rock, USA) and colleagues.

To compare asthma prevalence and morbidity among minority and low-income children from urban and rural environments, the team studied 6376 children aged between 4 and 17 years. Of these, 5412 were from the urban Little Rock School District and 964 were from the rural Marvell and Eudora school districts of Arkansas.

Overall, 85% of rural and 67% of urban children were Black, and 78% and 37%, respectively, had state-issued medical insurance.

Parental surveys were used to collect information on asthma diagnosis rates, asthma symptoms, medication use, and healthcare use.

Analysis revealed that doctor-diagnosed asthma rates were similar in both groups, at 19% in urban children and 20% in rural children.

However, children from rural areas had significantly higher levels of asthma-related morbidity than their counterparts from urban environments. Indeed, rural children were more likely to have suffered from recurrent breathing problems (odds ratio [OR]=1.9), recurrent cough (OR= 2.2), recurrent chest tightness (OR=1.8), and repeated episodes of bronchitis (OR=2.2) during the preceding 2 years than urban children.

Rural children were also more likely than urban children to have symptoms consistent with moderate-to-severe asthma, at 46% versus 35%, respectively.

However, there were no significant differences in healthcare use between groups, the researchers note in the Annals of Allergy, Asthma and Immunology.

Perry and team conclude: “Asthma prevalence was similar between representative rural and urban groups in Arkansas, but asthma morbidity was significantly higher in the rural group.”

They add: “Although the findings might be related to barriers to healthcare access and subsequent inadequate medication use, the prevalence of asthma and symptoms consistent with persistent asthma is compelling.

“The specific challenges to providing care and implementing interventions for children in a rural and underserved region must be considered to reduce the significant asthma burden.”

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Mark Cowen

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