Hispanic Children With Asthma: Morbidity

Hispanic children represent a large and growing segment of the poor and disadvantaged children in our country. Asthma and other chronic respiratory diseases have a significant impact on poor children. Yet there are few descriptions of the specific morbidities and barriers to health that Hispanic children with asthma encounter, and data on predictors of morbidity among these children are unavailable. The purpose of this study is to describe the morbidity associated with asthma in Hispanic children and to identify factors that predict morbidity. A group of Hispanic children with moderate asthma followed in the clinics of the University of Texas Health Science Center at San Antonio were studied. Children aged 6 to 16 years with at least two acute-care visits or one hospitalization for asthma during the previous year were enrolled. Data sources included standardized questionnaires, spirometry, medical records, and school attendance records. Seventy-eight Hispanic children were enrolled in the study (mean age = 9.4 ± 2.7 SD; 62% male). Fifty-two (67%) of children had been hospitalized previously. The other morbidity variables (mean ± SD) were number of days/week impaired (1.1 ± 1.2), number of days absent from school per year (13 ± 9.6), number of acute-care visits per year (3.3 ± 2.4), and number of hospital admissions per year (0.6 ± 0.8). The mean forced expiratory volume in 1 second/forced vital capacity was 79.3% (±9.1) and the mean forced expiratory flow, mid-expiratory phase, percent predicted was 69.9% (±25. 1). Thirty-four children (44%) were exposed to cigarette smoke in the home. Parents answered an average of 86% (±12%) of questions about asthma correctly, but they made more errors in answering medication questions. Mean Impact-on-Family score was high (45.6 ± 6.4). Multiple regression analysis showed that Total Impact-on-Family scores were significantly increased if there was a smoker in the household and decreased when knowledge about asthma was high. Spirometry results (n = 45) did not predict any of the morbidity variables. This study identifies two factors associated with morbidity in Hispanic children with asthma that must be addressed in an intervention program: knowledge about asthma and parental smoking in the home.