222223 Geographical variation in asthma prevalence within a state

Wednesday, November 10, 2010 : 11:20 AM - 11:35 AM

Stanley H. Weiss, MD, FACP, FACE , Department of Preventive Medicine & Community Health, UMDNJ - New Jersey Medical School, and UMDNJ - School of Public Health, Newark, NJ
Joshua Parks , Preventive Medicine and Community Health, UMDNJ - New Jersey Medical School, Newark, NJ
Daniel M. Rosenblum, PhD , Department of Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ
Objectives: Examine the geography and correlates of asthma prevalence in school-aged children throughout our state using SASR and Geographic Information Software (ArcEditorTM, Maptitude) based upon school level data. Design: New Jersey law enables children with a signed doctor's order to carry inhalers in school. NJ schools are required to have nurses; they are uniquely positioned to know how many students have asthma. In 2001, 2004, 2005, and 2007, school nurses were polled by a state-wide community health organization and asked how many students had asthma. Data were linked with annual school data from the National Center for Education Statistics' Common Core of Data and Private School Universe Survey. Sample: 1487 schools (40.5% of 3675 with at least one K-12 grade) responded 1 or more times representing 47.5% (783,199) of 1,650,327 students. Results: Asthma prevalence in NJ counties ranged from 6.5% to 11.2%, a nearly two-fold range. Several rural counties had unexpectedly high asthma prevalence. Mean prevalence overall was 8.4% (weighted by school size): 8.5% based on 1225 public schools, 7.9% based on 262 private schools. Study limitations will be discussed. School-level prevalence rate was positively correlated with % black students (r=.178, p<.0001), and negatively correlated with % Asian (r=-.149, p<.0001) and socioeconomic status, measured by % not receiving subsidized lunch (r=-.147, p<.0001). Prevalence clustered significantly (p<.01) according to the Moran's I statistic, both at the school level within counties and globally at the county level. Low-prevalence clusters were identified in some upper-class municipalities and high-prevalence clusters in some urban areas.

Learning Areas:
Assessment of individual and community needs for health education
Basic medical science applied in public health
Chronic disease management and prevention
Clinical medicine applied in public health
Planning of health education strategies, interventions, and programs
Public health or related research

Learning Objectives:
Describe the variation in asthma prevalence within a state. Evaluate the advantages and disadvantages of systematic data collection at the school level as compared to population based surveys.

Keywords: Asthma, Geographic Information Systems

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Past chair of the epidemiology section and past vice-chair of the APHA Science Board. Tenured professor of preventive medicine and community health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5104.0: Asthma epidemiology