ASTHMA IN NON-INNER CITY HEAD-START CHILDREN

Objective. Asthma is a significant cause of morbidity and mortality in children. The objective of this study was to determine whether the fe deral program Head Start in Dane County, Wisconsin, could be used as a mechanism to identify preschool-aged children with asthma. Design. Fi ve-year, cross-sectional survey of parents with children enrolled in H ead Start. Methods. Investigator-administered asthma screening questio nnaire to parents of enrolling Head Start children in Dane County, Wis consin. Measurements. Asthma prevalence and asthma-related health care use, including emergency department visits, hospitalizations, and med ication usage, were measured using an asthma screening questionnaire d eveloped by investigators. Results. Information was gathered on 2215 c hildren. The prevalence of physician-diagnosed asthma in the screened children was 15.8%. Parental reports of physician-diagnosed asthma wer e validated in a subset of 133 children, with a 98.5% confirmation rat e. Independent risk factors for asthma included male gender (relative risk, 1.4) and African-American ethnicity (relative risk, 1.4). Asthma -related morbidity was substantial with 26.7% of identified children h ospitalized for asthma and 54.5% with an emergency department visit du ring their lifetime. The majority of children (46.4%) were treated wit h intermittent, quick relief medications (beta-agonists) alone, wherea s only 6.1% were on daily, long-term controller medications. Conclusio ns. Asthma screening through a Head Start program provides an effectiv e means of targeting preschool-aged children from socioeconomic groups at high risk for asthma. Identification of children early in the dise ase course and those at high risk for asthma provides an ideal opportu nity for the implementation of preventive and therapeutic intervention s.