Estrada Robin Dawson, Ownby Dennis R
College of Nursing, University of South Carolina, Columbia, SC, USA.
Allergy & Immunology, Augusta University, Augusta, GA, USA.
Curr Allergy Asthma Rep. 2017 Jun;17(6):37. doi: 10.1007/s11882-017-0704-3.
Asthma is the most common chronic illness of children and adolescents in the USA. While asthma has been understood to disproportionately affect urban dwellers, recent investigations have revealed rural pediatric asthma prevalence to be very similar to urban and to be more closely correlated with socioeconomic and environmental factors than geographic location or population density.
Rural children experience factors unique to location that impact asthma development and outcomes, including housing quality, cigarette smoke exposure, and small/large-scale farming. Additionally, there are challenging barriers to appropriate asthma care that frequently are more severe for those living in rural areas, including insurance status, lack of primary care providers and pulmonary specialists, knowledge deficits (both patient and provider), and a lack of culturally tailored asthma interventions. Interventions designed to address rural pediatric asthma disparities are more likely to be successful when targeted to specific challenges, such as the use of school-based services or telemedicine to mitigate asthma care access issues. Continued research on understanding the complex interaction of specific rural environmental factors with host factors can inform future interventions designed to mitigate asthma disparities.
哮喘是美国儿童和青少年中最常见的慢性病。虽然人们一直认为哮喘对城市居民的影响尤为严重，但最近的调查显示，农村儿童哮喘患病率与城市非常相似，且与社会经济和环境因素的相关性比地理位置或人口密度更为密切。
农村儿童会经历一些因地理位置而产生的独特因素，这些因素会影响哮喘的发展和转归，包括住房质量、接触香烟烟雾以及小规模/大规模农业活动。此外，获得适当哮喘护理存在一些具有挑战性的障碍，对于生活在农村地区的人来说，这些障碍往往更为严重，包括保险状况、缺乏初级保健提供者和肺科专家、知识欠缺（患者和提供者双方）以及缺乏针对不同文化背景的哮喘干预措施。旨在解决农村儿童哮喘差异问题的干预措施，如果针对特定挑战，如利用学校服务或远程医疗来缓解哮喘护理可及性问题，则更有可能取得成功。持续开展研究以了解特定农村环境因素与宿主因素之间的复杂相互作用，可为未来旨在减少哮喘差异的干预措施提供参考。
