Milton B, Whitehead M, Holland P, Hamilton V
Department of Public Health, University of Liverpool, Liverpool, UK.
Child Care Health Dev. 2004 Nov;30(6):711-28. doi: 10.1111/j.1365-2214.2004.00486.x.
Asthma prevalence rates are high, and may be increasing in the Western world, particularly among children. The aim of this study was to evaluate the longer-term social and economic consequences of having asthma as a child and to determine whether adverse consequences are more severe for poorer children.
Results from published and unpublished, quantitative and qualitative studies were synthesized narratively to examine the impact of childhood-onset asthma on school attendance, academic achievement and employment in adulthood. The question of whether the impact differed for different social groups was also examined.
Twenty-nine good quality studies were identified, including in total 12 183 children with asthma or wheeze. Compared with asymptomatic children, those with asthma missed more days of school (additional absence as a result of asthma ranged from 2.1 to 14.8 days). Studies of academic achievement found that children with asthma performed as well as their healthy peers. The existing evidence on labour market performance is sparse, but there is an indication that people with asthma during childhood experience disadvantage in later employment. In an examination of consequences by social position, children with asthma from deprived areas were more likely to miss school than their more affluent peers, and minority ethnic children were also more likely to have poor school attendance. The only qualitative study suggested that children with asthma strove to participate fully in every aspect of their daily lives.
Although asthma limits children's daily activities and affects their social activities, this research synthesis found little evidence of major, adverse long-term social and economic consequences in studies reviewed. Further longitudinal research using comparison groups is needed to fill key gaps in the existing evidence base.
哮喘患病率很高，在西方世界可能还在上升，尤其是在儿童中。本研究的目的是评估儿童时期患哮喘的长期社会和经济后果，并确定贫困儿童的不良后果是否更严重。
对已发表和未发表的定量和定性研究结果进行叙述性综合分析，以研究儿童期哮喘对上学出勤率、学业成绩和成年后就业的影响。还研究了不同社会群体的影响是否存在差异这一问题。
共确定了29项高质量研究，其中包括总共12183名患有哮喘或喘息的儿童。与无症状儿童相比，哮喘儿童缺课天数更多（因哮喘额外缺课天数在2.1至14.8天之间）。学业成绩研究发现，哮喘儿童的表现与健康同龄人相当。关于劳动力市场表现的现有证据很少，但有迹象表明，儿童期患哮喘的人在后期就业中处于不利地位。在按社会地位对后果进行的调查中，贫困地区的哮喘儿童比富裕同龄人更有可能缺课，少数族裔儿童缺课的可能性也更大。唯一的定性研究表明，哮喘儿童努力充分参与日常生活的各个方面。
尽管哮喘限制了儿童的日常活动并影响其社交活动，但本研究综述发现，在所审查的研究中，几乎没有证据表明存在重大的长期社会和经济不良后果。需要进一步使用对照组进行纵向研究，以填补现有证据基础中的关键空白。
