Asthmatic Children Treated in School: A Population-Based Survey† 583

Abstract

Background: Asthma is the leading chronic illness in school-aged children. A community-based initiative to improve the care and school performance of children with chronic health problems was developed in E. Virginia as a partnership of public schools and health care providers. This study is part of a needs assessment to guide policy and programs for school-aged children. Study population: School children residing in Portsmouth and VA Beach, proximal cities in E. VA. Compared to VA Beach, Portsmouth has more child poverty (27% vs. 8%); black pop. (57% vs 16%); and school drop-outs (16% vs. 9%). Objective: To describe the pattern of asthma medication use in public schools compared to asthma hospitalization rates in school-aged children. Methods: School health databases developed for Portsmouth and VA Beach school districts included all students enrolled in 1995. The databases identified students administered asthma medication in school, their age, grade, race and gender. The 1995 Virginia Health Information dataset was used to analyze all hospitalizations for asthma among school-aged children (6-17 yrs) residing in the study cities.Results: In Portsmouth, 7.8% of students (N=15,489) received medication for asthma while in school; increasing slightly between grade school (6-10 yr olds; 7.4%) and middle/high school (11-17 yr olds; 8.2%). Administration of asthma medication in school occurred significantly(P<.05) more often among male (8.8%) than female (6.8%) and black (8.6%) than white (6.6%) students. In VA Beach, 3.5% of students (N=87,947) received medication for asthma while in school; decreasing slightly between grade school (3.8%) and middle /high school students (3.3%). Male gender and black race were significantly associated with increased asthma medication usage in VA Beach schools. The asthma hospitalization rate was 4.8 per 1000 school-aged children in Portsmouth compared to 0.8 per 1000 school-aged children in VA Beach. Risk of hospitalization compared to asthma medication use in schools was significantly higher for male and black students in both school districts.Conclusions: Treatment of asthma in school occurs relatively often in low-income, predominantly black urban areas. Such data are needed to focus local school health resources and to guide development of health care policy aimed toward improving care delivery to pediatric at-risk populations.