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Paul W. Newacheck, DrPH; Neal Halfon, MD, MPH

Arch Pediatr Adolesc Med. 2000;154:287-293.

Background  Although not widely recognized as such, asthma is the single most prevalent cause of childhood disability and has contributed to a substantial rise in the overall prevalence of disability among children during the past 25 years.

Objective  To provide a national profile of the prevalence, impact, and trends in childhood disability due to asthma. (Disability is a long-term reduction in the ability to participate in children's usual activities, such as attending school or engaging in play, due to a chronic condition.)

Methods  We derived our primary findings from a cross-sectional, descriptive analysis of 62,171 children younger than 18 years who were included in the 1994-1995 National Health Interview Survey.

Main Outcome Measures  Outcome measures include the presence of disability, degree of disability, restricted activity days, school absence days, and use of hospital and physician services. We also used data from the 1969-1970, 1979-1981, and 1994-1995 National Health Interview Surveys to assess trends in the prevalence of disability due to asthma.

Results  A small, but significant, proportion of children, estimated at 1.4% of all US children, experienced some degree of disability due to asthma in 1994-1995. Prevalence of disability due to asthma was higher for adolescents (odds ratio [OR], 1.64), black children (OR, 1.66), males (OR, 1.23), and children from low income (OR, 1.46) and single-parent families (OR, 1.37). Disabling asthma resulted in an annual average of 20 restricted activity days, including 10 days lost from school—almost twice the level of illness burden as experienced by children with disabilities due to other types of chronic conditions. Finally, prevalence of disabling asthma, as reported in the National Health Interview Survey, has increased 232% since 1969, the first year that electronic data are available from the survey. In contrast, prevalence of disability due to all other childhood chronic conditions increased by 113% over the same period.

Conclusions  Disabling asthma has profound effects on children. The social costs of asthma are likely to rise in the future if current trends in the prevalence of disabling asthma continue.

From the Institute for Health Policy Studies and the Department of Pediatrics, School of Medicine, University of California, San Francisco (Dr Newacheck), and the School of Public Health, and the Department of Pediatrics, School of Medicine, University of California, Los Angeles (Dr Halfon).

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