RELATIONSHIPS OF RACE AND SOCIOECONOMIC-STATUS WITH PREVALENCE, SEVERITY, AND SYMPTOMS OF ASTHMA IN CHICAGO SCHOOL-CHILDREN

Background: Asthma mortality rates in Chicago are among the highest in the United States, with substantially greater rates in poor and minor ity populations. How much of the differential can be attributed to dif ferences in prevalence versus severity or access to care has not been determined. Objective: To examine rates of asthma prevalence, severity , and symptoms and to explore the relationships of these rates to race and socioeconomic status in a random sample of Chicago school childre n. Methods: Self-administered survey. Results: Overall, rates of asthm a were higher than previously reported, with 16% of students in the st ratified cluster random sample of 3,670 children in the 7th and 8th gr ades having had asthma. Prevalence rates were significantly higher in schools with >98% African Americans than in other schools, with the hi ghest prevalence rates seen in African American schools in low income neighborhoods. Rates were associated with the percent of African Ameri can children in the school and with median income of the school's cens us tract. Relationships were most consistent with indices of more seve re disease. Conclusions: Asthma prevalence is higher than previously n oted, with rates greatest in minority and low income populations. Diff erences are more striking for measures of severity than for symptoms o f wheezing, but are far less than previously reported differences in m ortality, suggesting that additional factors, such as differential acc ess to continuous health care, may be affecting high death rates from asthma in Chicago.