Factors contributing to risks for pediatric asthma in rural Saskatchewan.

BACKGROUND

Rural children have lower reported rates of asthma compared with urban children. Although reasons for these differences remain unclear, 3 possible explanations exist: (1) environmental differences, (2) variations in health care access, and (3) variations in health risk behaviors.

OBJECTIVE

We investigated asthma among children living on farms and in small towns and its potential determinants, including personal, behavioral, and environmental factors.

METHODS

School children (n = 842, ages 6-13; participation rate = 72.0%) were involved in a 2003 cross-sectional study. Their parents completed a lung health survey that included questions about asthma, asthma-like symptoms, and potential determinants of asthma (demographic, environmental, health risk behaviors). Participating children were classified into farm dwellers (live on farm or acreage) and small town dwellers. Multiple logistic regression was used to investigate the association between asthma and wheeze with demographic, environmental, and behavioral exposures with simultaneous adjustment for confounders.

RESULTS

Asthma and wheeze prevalence was not significantly different between farm and small town areas (current asthma: 16% vs 13%, respectively; current wheeze: 27% vs 21%, respectively) and followed consistent patterns. Factors associated with diagnosed asthma were dampness (odds ratio [OR] = 1.85; 95% confidence interval [CI] = 1.08-3.17), with enrollment in daycare found to be protective (OR = 0.53; 95% CI = 0.33-0.85). Being obese or overweight was associated with wheeze (OR = 1.77; 95% CI = 1.06-2.97).

CONCLUSION

Given the differences between areas and the associations between environmental risk factors and obesity with asthma and wheeze, the study findings support environment and health risk behavior explanations for the observed geographic variations.