Patrick W. Sullivan
BOSTON — School-aged children with both obesity and asthma miss more school, have higher expenditures and exhibit both poorer health and more worry than children of normal weight, according to a recent presentation at the American College of Allergy, Asthma and Immunology’s Annual Scientific Meeting.
“Obese children have a higher prevalence of asthma in the United States and seem to have worse outcomes on a variety of clinical, economic, psychological, social and functional measures,” Patrick W. Sullivan, PhD, from the Rueckert-Hartman College for Health Professions at Regis University, told Infectious Diseases in Children. “More aggressive drug therapy, asthma management programs and cultural awareness may be needed to address health disparities among these children.”
To assess how outcomes related to asthma and obesity affect school-aged children, the researchers conducted a cross-sectional analysis of a nationally representative group of children between the ages of 6 and 17 years through the 2007-2014 Medical Expenditure Panel Survey. The researchers examined data for asthma-specific ED and inpatient visits, as well as expenditures (adjusted to 2015 U.S. dollars). Sullivan and colleagues also inspected data regarding health status and missed school days.
The Columbia Impairment Scale was used on health status questionnaires, as was Children with Special Healthcare Needs and the Child Health Questionnaire. Perceived health status was also collected from these surveys. The researchers used negative binomial regression to inspect ED and inpatient visits, generalized linear models with log-link to review expenditures and logistic/ordered logistic regression to analyze health status.
Of the 43,915 school-aged children included in this study without asthma, 4.7% were considered to be obese. Asthma was observed in 6,751 children, with 7.4% of these children being obese. School-aged children with obesity were more likely to have asthma than children who were not obese (OR 1.67; P < .001). When compared with school-aged children of normal weight, obese children were placed in inpatient settings 5.3 times more due to asthma-specific symptoms and had higher asthma-specific medical expenditures.
Health problems on the Columbia Impairment Scale — such as unhappiness or sadness and trouble playing sports or having hobbies — were more prevalent in obese children (P < .05). These children also possessed poorer health and more worry on the Child Health Questionnaire (P <.01), had less perceived physical health (P < .001) and were absent from school more frequently than children of normal weight.
“Results of this study suggest that non-asthma interventions such as weight loss, dietary and activity counseling are important to a more holistic medical care model for overweight/obese children with asthma,” Sullivan said in an interview. “Awareness of these services and vigilance using them may be more important for asthma-care providers and specialists.”–by Katherine Bortz
Sullivan P, et al. P202. The association between asthma, obesity and outcomes among school-aged children in the U.S. Presented at: The ACAAI Annual Meeting; Oct. 26-30, 2017; Boston, MA.
Disclosure: Infectious Diseases in Children was unable to confirm relevant financial disclosures prior to publication.