Odds of asthma significantly higher among children with disability or delay
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Asthma prevalence estimates were 10 percentage points higher among children with a developmental disability or delay than among children without one, according to a study in JAMA Network Open.
Sarah E. Messiah, PhD, MPH, a professor of epidemiology, genetics and environmental studies at the University of Texas, and colleagues analyzed data on 71,811 children included in the 2016 and 2017 National Survey of Children’s Health. in their study. Participants had a mean age of 8.6 years. Of them, 7.9% (n = 5,687) had asthma and 15.3% (n = 11,426) had at least one disability.
Among children with at least one disability, 16.1% (95% CI, 14.3%-17.8%) had asthma, compared with 6.5% (95% CI, 6%-6.9%) of children without any disabilities. Messiah said she was surprised by the results.
“We did not expect to see that the overall asthma prevalence estimates were 10 percentage points higher in children with a disability vs. children without a disability,” Messiah told Healio. “That is, the odds of asthma were significantly higher in children with a disability or delay vs. children with no disability or delay.”
The widest asthma prevalence disparity occurred among children with a hearing loss vs. those without hearing loss, 22% (95% CI, 13.2%-30.7%) vs. 7.7% (95% CI, 7.3%-8.2%), respectively.
According to Messiah and colleagues, similar trends were found in those with cerebral palsy, a learning disability, ADHD, a developmental delay, autism spectrum disorder, intellectual disability, seizures and speech problems.
“While current pediatric guidelines do not list a disability or delay as a risk factor for asthma, our findings could lead to more discussion of challenges children with asthma and a disability diagnosis face and help to bridge the gap between their health care needs and increasing their quality of life,” Messiah said.
Asthma prevalence estimates were significantly higher among ethnic minority children with a developmental disability compared with non-Hispanic white children with a developmental disability, 19.8% (95% CI, 16.6%-23%) vs. 12.6 % (95% CI, 11.1%-14%).
“It has been well documented that the prevalence, morbidity and mortality of asthma are higher in ethnic minority children,” Messiah said. “This is likely to be due to multisystem dynamic effects such as the differences in the quality of support and education available to the two groups. Health care, health insurance, and housing are additional potential explanatory factors for this finding.”
Messiah said the findings are important to both clinical and public health. She said pediatricians and other developmental specialists caring for children with a disability should consider screening for asthma to begin interventions sooner.
“Screening is particularly important to conduct in ethnic minorities with disabilities, given their even greater risk,” Messiah said. “Also, both asthma and disabilities in children are important determinants of school absenteeism, with the subsequent risk of educational delays. Asthma, when detected early and managed early, can lessen the impact it has on quality of life and missed school days.”
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