March 27, 2006
By ELIZABETH HAMILTON, Courant Staff Writer
While there is evidence pointing to
a possible stabilization of asthma rates across the nation, the
disease remains on the rise in New England, especially among low-income
adults, a new study has concluded.
The study, conducted by The New England
Asthma Regional Council, found that nearly 15 percent of adults
and 14 percent of children living in New England have been diagnosed
with asthma at some point in their lives. This represents roughly
2.1 million people - up from 1.7 million three years ago.
By several measures, asthma rates in
New England outstripped the rest of the country. The lifetime asthma
rate for adults nationally, for example, was 13 percent - two points
lower than New England. Among the states in the region, Connecticut
had the highest, at 15.3 percent.
"It's just extraordinarily frustrating
when you see rates going up and up," said Laurie Stillman,
executive director of the council. "Even though we don't know
what is causing asthma, it's an eminently controllable disease.
But it seems we are not doing a good enough job controlling it."
Although the study does not point to
any single reason, experts say it's probably attributable to a number
of different factors, such as the region's older housing stock,
smoking, and air pollution from diesel fuel, industrial facilities
and out-of-state power plants.
Asthma is a chronic respiratory disease
that, if left untreated, can cause permanent lung damage, disability
and even death. In 2003, nearly 30 million people had been diagnosed
with asthma in the United States, according to the National Center
for Health Statistics.
Among the study's major findings:
Asthma in adult women is much higher
than in men (12.5 percent vs. 7.1 percent) and is growing significantly.
The disease is more common in boys
(11.4 percent vs. 7 percent for girls).
Hispanic children have a significantly
higher rate of asthma than non-Hispanic white children, while African
American children have a somewhat higher rate than non-Hispanic
Children living with someone who smokes
have a 44 percent greater chance of getting asthma.
Poor adults and children are much more
likely to have asthma, and children in the lowest income bracket
have double the rates of asthma compared with those in the highest
Asthma rates were significantly higher
among adults who were obese (13.1 percent vs. 8.7 percent) than
for those not overweight or obese.
The findings, while not surprising
to those who work in the field, were somewhat sobering.
"I think it's very significant"
said Paula Schenck, assistant director of the Center for Indoor
Environments and Health at the University of Connecticut Health
Center. "As we learn more, improving our environments looks
to me like it could really make a difference."
Dr. Craig Schramm, chief of the pediatric
pulmonary division at the Connecticut Children's Medical Center
in Hartford, agreed.
"Our cities are old; there is
decaying infrastructure; there is the traffic issue," Schramm
said. "There is the density of life when you're in an urban
area - more pollution, more smoking, more contacts, more everything."
Schramm said doctors at the children's
hospital have noticed the correlation between urban problems - homes
and schools that suffer from mold problems, cockroach infestations
and the like - and asthma in children, all of which can make the
illness very difficult to treat.
Even if children take preventive medicine
to control their asthma, Schramm said, it can be impossible to address
the underlying reasons for the asthma in the first place because
low-income families can either not afford to move into better housing
or put in place the safeguards that the doctors recommend.
"I tell people it's like having
a pebble in your shoe," Schramm said. "If the thing that
is inducing your asthma is still there, it's hard to control."
In Connecticut, the study found that
13.7 percent of children under 18 have been diagnosed with asthma
at some point in their lives and 8.7 percent report they currently
For Connecticut adults, the numbers
were 15.3 percent and 9.7 percent.
The study also outlined the effects
of the disease. In New England, more than 30 percent of adults who
said they have asthma reported being limited by the illness, 22
percent said they were in fair or poor overall health, and 17 percent
reported frequent mental distress. About 9 percent of adults with
asthma reported being unable to work.
"For 9 percent of adults to say
they can't work, that's huge," Stillman said. "This all
says to me that we have a particular problem in the Northeast and
that the numbers of people who are adversely affected on a day-to-day
level and the way that is affecting our economy in terms of loss
of productivity and health care costs is also huge."
Reprinted with permission of the Hartford Courant.
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