title: Examining household asthma management behavior through a microeconomic framework.
abstract: National guidelines on the effective management of pediatric asthma have been promoted for over 20 years, yet asthma-related morbidity among low-income children remains disproportionately high. To date, household and clinical interventions designed to remediate these differences have been informed largely by a health behavior framework. However, these programs have not resulted in consistent sustained improvements in targeted populations. The continued funding and implementation of programs based on the health behavior framework leads us to question if traditional behavioral models are sufficient to understand and promote adaptation of positive health management behaviors. We introduce the application of the microeconomic framework to investigate potential mechanisms that can lead to positive management behaviors to improve asthma-related morbidity. We provide examples from the literature on health production, preferences, trade-offs and time horizons to illustrate how economic constructs can potentially add to understanding of disease management. The economic framework, which can be empirically observed, tested, and quantified, can explicate the engagement in household-level activities that would affect health and well-being. The inclusion of a microeconomic perspective in intervention research may lead to identification of mechanisms that lead to household decisions with regard to asthma management strategies and behavior. The inclusion of the microeconomic framework to understand the production of health may provide a novel theoretical framework to investigate the underlying causal behavioral mechanisms related to asthma management and control. Adaptation of an economic perspective may provide new insight into the design and implementation of interventions to improve asthma-related morbidity in susceptible populations.
authors.affiliation: University of California, Berkeley, Berkeley, CA, USA University of Wisconsin-Madison, Madison, USA sheryl.magzamen@colostate.edu.
authors.forename: Sheryl
authors.initials: S
authors.lastname: Magzamen
authors.affiliation: University of Massachusetts, Amherst, MA, USA.
authors.forename: Sylvia J
authors.initials: SJ
authors.lastname: Brandt
authors.affiliation: University of California, Berkeley, Berkeley, CA, USA.
authors.forename: Ira B
authors.initials: IB
authors.lastname: Tager
mesh_terms: D001249:Asthma / Q000191:economics* / Q000523:psychology* / Q000628:therapy; D002648:Child; D015438:Health Behavior; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D018803:Models, Economic; D008960:Models, Psychological; D057240:Patient Preference; D018802:Patient-Centered Care; D018570:Risk Assessment; D012648:Self Care / Q000191:economics* / Q000523:psychology*; D013997:Time Factors
keywords: child health; chronic disease management; health behavior; health disparities; research design; social inequalities