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Black schoolchildren at higher risk for ambulance-treated asthma attacks
Black schoolchildren were significantly more likely to require emergency medical crews to treat ‘uncontrolled’ asthma attacks at Houston public schools and at home, compared with white and Hispanic students, according to recent study.
In addition, school zones with the highest rates of ambulance-treated asthma attacks were more likely to have higher percentages of socioeconomically disadvantaged students and were less likely to have a school nurse on staff.
“In addition to parents and local health care providers, school nurses play an important role in assisting children in managing asthma,” Loren H. Raun, PhD, assistant research professor at Rice University, and colleagues wrote. “Because children spend a substantial portion of their day in school, school nurses have the opportunity to positively influence the health of children with asthma through education, health services and overall support for asthma management.”
In a previous study, Raun and colleagues had examined air quality and health in Houston to ascertain where in the city and at what times of day patients with asthma would most likely be at risk.
To expand upon this data and target asthma interventions to school populations at greatest risk, Raun and colleagues identified school zones with high rates of uncontrolled asthma by examining ambulance-treated asthma attacks (n = 1,826) among children aged 5 to 18 years from 2004 to 2013.
The researchers calculated incidence rates for elementary, middle and high school levels within Houston, with each school zone ranked within school level based on the ambulance-treated asthma attack rate. The zones with incidence rates in the upper quartile had the highest rates, which were compared with other school zones; the researchers placed an emphasis on demographics, location and timing of the asthma attacks.
According to study results, black children accounted for the largest percentage of ambulance-treated asthma cases: 72% among elementary school students, 81% among middle schoolers and 79% among high schoolers. In comparison, Hispanic children were less likely to require emergency services for an asthma attack: 23% of elementary students, 15% of middle school students and 15% of high school students.
The researchers also observed that, when compared with other school zones with similar school levels, the high-rate school zones exhibited five times as many ambulance-treated asthma events for elementary schools, three times as many for middle schools and two times as many for high schools. High-rate areas were most likely to be geographically contiguous, and exacerbations were most likely to happen mid-day or in the evening.
“Mapping the contiguous school zones across all levels of schools may help decision-makers design interventions that take advantage of the geographic proximity of school zones with high rates of uncontrolled asthma by creatively viewing staffing and resource sharing options or emphasizing the needs of students across the K-12 continuum,” Raun and colleagues wrote. “In this analysis, with 80% of elementary, 67% middle and 80% of high schools with high rates of ambulance-treated asthma attacks in contiguous school zones, there would appear to be value in considering the potential of how to maximize the needs of the school zones as a whole.” — by Katherine Bortz
Disclosure: This study was supported by Houston Endowment and the City of Houston.
