The continuing problem of asthma in very young children: a community-based participatory research project.
BACKGROUND
Asthma is a chronic health condition that has a disproportionate effect on low-income minority children who reside in large urban areas. African-American children report significantly higher rates than the general population of children and have more-severe asthma and poorer outcomes. This article describes the prevalence of asthma in a particularly vulnerable group: children aged 2-5 participating in Detroit Head Start programs.


METHODS
Health screens were distributed to caretakers of all children attending 6 Head Start agencies. Caretakers of children identified with active asthma symptoms were asked to complete an in-depth phone interview regarding their child's asthma.


RESULTS
Data collected from 3,254 children (78% African American) revealed that 27% met criteria for probable asthma. Of those with persistent symptoms, 26% were undiagnosed, and 21% were untreated. Baseline data (n = 675) showed that 95% had a regular doctor, but 36% had had no health care visit for asthma in the previous year. Of children with a history of asthma episodes, more than half reported 3 or more episodes in the preceding year. Forty-three percent of caretakers had discussed their child's asthma with Head Start, and 31% had an asthma action plan on file with Head Start.


CONCLUSIONS
Asthma remains a significant problem in this population, especially for African Americans, as evidenced by high levels of undiagnosed children with persistent symptoms and questions regarding the care they receive. Head Start is a way to reach young children with asthma, but may need help to develop the capacity to assist families.
Nelson
Belinda Wilburn
BW
Center for Managing Chronic Disease, University of Michigan, 109 Observatory, Ann Arbor, MI 48109, USA. belindan@umich.edu
Awad
Daniel
D
Alexander
Jeffrey
J
Clark
Noreen
N