McLean Diane E, Bowen Shawn, Drezner Karen, Rowe Amy, Sherman Peter, Schroeder Scott, Redlener Karen, Redlener Irwin
Department of Psychiatry, Columbia University/New York State Psychiatric Institute, New York City, NY 10032, USA.
Arch Pediatr Adolesc Med. 2004 Mar;158(3):244-9. doi: 10.1001/archpedi.158.3.244.
In the United States, children of color, children who live in urban medically underserved communities, and children whose families have limited economic resources have excessively high rates of asthma. The identification of high-risk subgroups of underserved children is crucial for understanding the determinants and scope of the childhood asthma epidemic and for developing successful interventions.
To determine the population prevalence of asthma among homeless children.
Cross-sectional study.
Three family shelters in New York City.
A total of 740 children whose families entered 3 family shelters from June 30, 1998, to September 18, 1999.
Prior physician asthma diagnosis, current asthma symptoms using National Asthma Education and Prevention Program symptom criteria, current medications, and emergency department use in the past year.
Of the children, 26.9% had a prior physician diagnosis of asthma. In addition, 12.9% of the children without a prior physician diagnosis of asthma reported symptoms consistent with moderate or severe persistent asthma. Overall, 39.8% of homeless children in New York City are likely to have asthma. Few children with persistent asthma received any anti-inflammatory treatment. Almost 50% (48.6%) of children with severe persistent asthma had at least 1 emergency department visit in the past year; 24.8% of children with symptoms of mild intermittent asthma had at least 1 visit.
The prevalence of asthma among a random sample of homeless children in New York City is likely to be 39.8%-more than 6 times the national rate for children. Asthma in homeless children is also likely to be severe and substantially undertreated.
在美国，有色人种儿童、居住在城市医疗服务欠缺社区的儿童以及家庭经济资源有限的儿童患哮喘的比例过高。确定医疗服务欠缺儿童中的高危亚组对于理解儿童哮喘流行的决定因素和范围以及制定成功的干预措施至关重要。
确定无家可归儿童中哮喘的人群患病率。
横断面研究。
纽约市的三个家庭收容所。
1998年6月30日至1999年9月18日期间进入三个家庭收容所的740名儿童及其家庭。
医生先前对哮喘的诊断、使用国家哮喘教育和预防计划症状标准评估的当前哮喘症状、当前用药情况以及过去一年中急诊就诊情况。
这些儿童中，26.9%曾被医生诊断为哮喘。此外，12.9%先前未被医生诊断为哮喘的儿童报告有符合中度或重度持续性哮喘的症状。总体而言，纽约市39.8%的无家可归儿童可能患有哮喘。很少有持续性哮喘儿童接受任何抗炎治疗。近50%（48.6%）的重度持续性哮喘儿童在过去一年中至少有1次急诊就诊；24.8%有轻度间歇性哮喘症状的儿童至少有1次就诊。
纽约市无家可归儿童随机样本中哮喘患病率可能为39.8%，是全国儿童患病率的6倍多。无家可归儿童的哮喘也可能较为严重且治疗严重不足。
