Asthma in rural America.
OBJECTIVE
To examine current trends of asthma prevalence, diagnosis, and utilization of care in rural areas, increase awareness about asthma disease burden, and provide general recommendations for improving care in this setting.


METHODS
MEDLINE searches were conducted for articles published from 1966 onward, with human subjects and the English language as descriptors. Other terms used included undiagnosed frequent wheezing, hygiene hypothesis, atopic sensitization, endotoxin, telemedicine, and asthma prevalence and care in rural or urban areas.


METHODS
Review and original research studies that reported on asthma care in rural areas were selected for evaluation.


RESULTS
Contrary to common belief, evidence suggests that asthma prevalence of rural and urban youth is comparable in the United States and may indeed be higher in rural areas. Data are not available to determine prevalence rates for rural adults in the United States. This review presents data suggesting that the utilization of asthma care among rural and urban residents may not be comparable. Rural residents are confronted with certain barriers to care that are not as common in the urban setting. These include lack of health care insurance, geographic obstacles to obtaining care, inability of getting suitable appointments, scarcity of health care professionals, and poor access to information about asthma.


CONCLUSIONS
Current literature suggests that asthma in rural areas may be underdiagnosed and deserves additional study. Improving formal and continuing education of health care professionals, compensating for health care shortages by using existing resources, and facilitating patient support and education are some of the ways to address the special needs faced by rural residents.
Ownby
Dennis R
DR
Department of Pediatrics, Medical College of Georgia, Augusta, Georgia 30912, USA. downby@mail.mcg.edu
D001249:Asthma / Q000175:diagnosis* / Q000628:therapy*; D004781:Environmental Exposure; D006297:Health Services Accessibility; D006801:Humans; D019035:Rural Health Services / Q000706:statistics & numerical data*; D014481:United States