Asthma has been increasing in the United States over several
decades. This increase is most apparent among children, especially
those living in the inner city. Approximately 15 million Americans
suffer from asthma. Annually, in the United States, about 500,000
asthma-related hospitalizations occur and 5,000 people die.
NIAID recently completed the first five-year phase of its
National Cooperative Inner-City Asthma Study with more than 1,500
children, ages 4 to 11, living in inner cities. Nearly 75 percent of
these children were African-Americans and 20 percent were Hispanic.
The researchers found that asthma morbidity was related to
environmental exposures, such as indoor allergens and passive
cigarette smoke, to psychological problems of both the children and
their caretakers, and to problems with access to medical care and
appropriate medications. In the study, asthma was more severe in
the approximately 50 percent of the patients who reported significant
barriers to access to medical care.
Families in inner cities face a wide variety of problems related
to poor housing, lack of insurance, and to difficulties in accessing
medical care and referrals to smoking cessation programs, among
other issues. In view of the study findings, scientists developed a
broad-based intervention centered around the use of an asthma
counselor, who was a trained social worker. The counselor did not
provide medical care or interact with the patient's physician, but
instituted educational, behavioral and environmental interventions
tailored to the specific needs of individual children and their families.
These efforts resulted in significant reductions in symptoms and
doctor visits for asthma.
Researchers will discuss details of the study at the American
Academy of Allergy Asthma and Immunology meeting on Saturday,
February 22, from 2:15 p.m. to 4:45 p.m. in the Moscone Convention
Center in San Francisco.
The moderators of the session on inner-city asthma are Daniel
Rotrosen, M.D., chief of the Asthma, Allergy and Inflammation Branch
and Ernestine T. Smartt, R.N., director of the Office of Epidemiology
and Clinical Trials in NIAID's Division of Allergy, Immunology and
Panelists include: H. James Wedner, M.D., Washington
University, in St. Louis, Mo.; Richard Evans, III, M.D., M.Ph.,
Children's Memorial Hospital in Chicago, Ill.; Peyton Eggleston, M.D.,
Johns Hopkins University in Baltimore, Md.; and Herman Mitchell,
Ph.D., New England Research Institute in Watertown, Mass.
NIAID, a component of the National Institutes of Health (NIH),
conducts and supports research to prevent, diagnose and treat
illnesses such as AIDS and other sexually transmitted diseases,
tuberculosis, asthma and allergies. NIH is an agency of the U.S.
Department of Health and Human Services.
NIAID press releases, fact sheets and other materials are
available on the Internet via the NIAID home page at