Warman Karen, Silver Ellen Johnson, Wood Pam R
Department of Pediatrics, Division of General Pediatrics, Albert Einstein College of Medicine/Children's Hospital at Montefiore, Bronx, New York 10461, USA.
J Asthma. 2009 Dec;46(10):995-1000. doi: 10.3109/02770900903350481.
Bronx children have higher asthma prevalence and asthma morbidity than other US children.
To compare risk factors for asthma morbidity present in Bronx children with those of children from other US inner-city areas.
Cross-sectional, multi-state study of 1772 children ages 5-11 yrs. old with persistent asthma. Parental responses to the Child Asthma Risk Assessment Tool for 265 Bronx children are compared with those of 1507 children from 7 other sites (1 Northeast, 2 South, 2 Midwest, 2 West).
Bronx children were significantly more likely to be sensitized to reported aeroallergens in their homes than were children from the other sites (86% vs. 58%; p < .001). More Bronx parents reported household cockroaches (65% v 20%; p < .001), mice (42% v 11%; p < .001), and rats (7% v 3%; p < .001); using a gas stove to heat the home (20% v 9%; p < .001); and visible mold (48% v 25%; p < .001). Bronx parents were more likely to report pessimistic beliefs about controlling asthma (63% v 26%; p < .001) and high parental stress (48% v 37%; p < .01).
Compared with other inner-city children with asthma, Bronx children are more likely to be exposed to household aeroallergens to which they are sensitized and have poor housing conditions. Their parents are more likely to report low expectations for asthma control and high levels of psychological stress. Interventions that address these identified needs may help to reduce the disproportionate burden of asthma morbidity experienced by Bronx children.
布朗克斯区儿童的哮喘患病率和哮喘发病率高于其他美国儿童。
比较布朗克斯区儿童与美国其他市中心城区儿童哮喘发病的危险因素。
对1772名5至11岁患有持续性哮喘的儿童进行横断面多州研究。将265名布朗克斯区儿童家长对儿童哮喘风险评估工具的回答与来自其他7个地点（1个东北部、2个南部、2个中西部、2个西部）的1507名儿童家长的回答进行比较。
与其他地点的儿童相比，布朗克斯区儿童对家中报告的空气过敏原致敏的可能性显著更高（86%对58%；p<.001）。更多布朗克斯区的家长报告家中有蟑螂（65%对20%；p<.001）、老鼠（42%对11%；p<.001）和大鼠（7%对3%；p<.001）；使用燃气炉取暖（20%对9%；p<.001）；以及可见霉菌（48%对25%；p<.001）。布朗克斯区的家长更有可能报告对控制哮喘持悲观信念（63%对26%；p<.001）和父母压力大（48%对37%；p<.01）。
与其他市中心城区哮喘儿童相比，布朗克斯区儿童更有可能接触到使其致敏的家庭空气过敏原，且住房条件较差。他们的父母更有可能报告对哮喘控制期望较低和心理压力水平较高。针对这些已确定需求的干预措施可能有助于减轻布朗克斯区儿童所经历的不成比例的哮喘发病负担。
