247544 There is significant local geographic variation in asthma prevalence among school children

Tuesday, November 1, 2011: 9:20 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
Limited data exist about local asthma prevalence (AP). Administrative databases (Emergency Department, Hospital Discharge records) primarily reflect acute asthma exacerbation or severe disease. Population-based surveys have insufficient power to examine local variation due to limited sample sizes. NJ State law enables children with signed doctor's orders to carry inhalers in school; all K-12 schools are required to have a nurse. These nurses are uniquely positioned to know how many students have asthma. In 2001, 2004, 2005, 2007 & 2010, school nurses were surveyed by a state-wide asthma consortium. Each survey asked how many students had asthma. These data were linked with census data and annual school level data from the NCES Common Core of Data & Private School Universe Surveys. 3009 survey responses were received. 2469 had asthma data, representing 1609 schools (1316 public) with at least one K-12 grade; these account for 49% of the NJ student population. We used SASŪ & Geographic Information Software for analyses. Statewide mean AP (including RAD; weighted by school size) in public schools was 9.1%, with AP in 21 counties ranging from 7.6%-13.2%. Significant clustering existed among counties as well as local levels (municipalities and school district); the patterns will be shown. There was no significant correlation between AP and county or municipality population density. AP varied little across grade levels but was higher in special needs schools. Reactive airway disease as a diagnosis was much less common in high schools than in lower grades. Further research is needed to understand the significant AP geographic variation.

Learning Areas:
Assessment of individual and community needs for health education
Chronic disease management and prevention
Public health or related research

Learning Objectives:
Describe the extent to which asthma prevalence varies when examined at the local level Discuss the descriptive epidemiology of asthma may differ for varying levels of disease severity

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an established epidemiologist who has conducted extensive research about asthma, and a tenured professor of preventive medicine and community health and of quantitative methods.
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.