Texas minority children are at greater risk of asthma, according to recent reports. One million children in Texas are considered asthmatic - more than ten percent of all children in the country diagnosed with the disease - and African-American and Puerto Rico, children are six times more likely to die than their counterparts, according to a report of the National Center for Health Statistics. In the southeastern U.S. alone, including the Galveston-Houston area, 76,450 children under fourteen years old and under are suffering from the disease. In 1997, 10,600 visits to emergency room care were related to childhood asthma, and over 200,000 hospitalizations in the state are still reported every year due to illness.
Part of the problem, experts say, is the industrialization. Dr. David Rosenstreich, MD, director of the division of allergy and immunology at Albert Einstein College of Medicine in New York, reports that the incidence of the disease are increasing not only in America but also in more developed countries. Twenty million Americans currently living with the potentially fatal disease, and this number is likely to increase.
Dr. Rosenstreich, who also served as principal investigator on the study of asthma InnerCity, which aims to identify factors associated with the development of asthma in children, says genes, allergy, environmental and socioeconomic factors related to quality and access to care are major contributing factors. Inner-city children in urban areas like Dallas, Austin and Houston, are much more vulnerable to factors that may cause or aggravate symptoms of the disease, and are much less likely to have quality health insurance and access outpatient medical care. This seems to validate one of the studies published this year by the nonprofit organization, the Commonwealth Fund, which provides that the lack of health insurance is directly related to reduced access to care.
"If you look at the neighborhood kids, who are sensitive to allergens increasingly exposed to allergens at higher levels in their homes, the allergens that are difficult to avoid," said Dr. Andrew Liu, the National Jewish Medical Center in Denver, which is also part of the Inner-City Asthma Consortium. The Consortium, funded by the federal government involved ten medical centers in the country, is designed to assess the severity of asthma in cities, and test treatments that block allergic reactions related.
Perhaps even more worrying is that the risk of disease increases significantly with race. Twenty percent of children suffer from asthma in Puerto Rico and three percent of black children did not, compared to eight percent of the national youth population. In the past eight years, the asthma mortality rate has declined - except in the case of minority children. Part of this could be due to genetic characteristics that make certain minorities like African-Americans more susceptible to allergies and side effects that accompany the abuse of rescue resources. But genetics are not sufficient to explain such a huge difference.
Among minority children, "the prevalence of asthma is approximately forty percent higher but the difference is negative in the results of three times, four times greater for hospitalizations," said researcher Dr. Laura Akinbami National Center for Health Statistics. "Because we have the tools to prevent these things, reaching the level of a public health crisis."
The scandal is particularly relevant when one considers that the lack of health insurance could be one of the main culprits. Poor children have less access to outpatient care - which has been tested. Many also have health insurance - 1. 2 million in Texas. These factors, combined with the non-profit organization that studies confirm that lack of access to quality health care is linked to lack of health insurance strongly suggests that the lack of health insurance is a factor of poor management of asthma in children. Asthma is a disease that can be controlled with good management, like many doctors willing to report, but this includes regular medical care, which is much more difficult for poor families with inadequate coverage or not health . Instead, these families tend to rely on emergency rooms for acute attacks.
Texas Children's Hospital in Houston, which is one percent of all patients with childhood asthma in the United States, working on this issue through the educational initiative, Texas Emergency Department Asthma Surveillance (TEDAS). TEDAS is designed to educate families about the management of the disease, and doctors more accurately diagnose the severity of the child and the chronicity. Pediatric asthma patients seen through the Children of Texas and four other participants in the program of emergency services in hospitals, were entered into a database in which its demography and its diagnostic and medical evaluations have occurred. Then participated in an educational intervention based on. Asthma educators spent about thirty minutes with each patient, and then followed up in two weeks, after three months to evaluate program effectiveness.
The results of TEDAS, a very simple initiative, which were important. Emergency Department staff has been able to better assess the chronicity of patients and severity of people, even young patients' families and carers feel more confident in their ability to handle the situation well — medical visits for asthma has increased among participants. Moreover, the program has reduced the number of subsequent visits of participants to the emergency room of forty percent.
"We believe that projects such as laboratories TEDAS development of models that can be replicated throughout the country," said Gary Rachelefsky, MD, TEDAS adviser and former president of the American Academy of Allergy, Asthma ed 'Immunology.
Other states have similar programs with similar results. The five-year campaign in New York, Childhood Asthma Initiative, a reduction in asthma hospitalizations in third. In central Connecticut, and the educational program focuses on breathing also significantly reduce emergency room visits and hospitalizations.
"In a way, each service of [emergency] visit is a failure," said Mariana Sockrider, MD, Texas Children's Hospital. "The management of asthma often boils down to good care and visits. Ideally, if families take control of asthma in children - the following plans of action, drug use and drivers to communicate with their primary care providers - the majority of the Department [emergency] visits are not necessary. "
What doctors give the impression of lack, however, is the extent to which the lack of health insurance management quality may hinder this process. It is difficult if not impossible for poor families without health insurance to provide the drugs needed to see the doctor several times a year, and continuously monitor the activities of their children. TEDAS, and other initiatives are vital, but so, too, efforts to ensure that families are provided. Similar results can be seen if stronger action was carried out in these low-income children and affordability of health insurance plans.
Massachusetts could be in something with its demand that all people receiving some form of health coverage, but that these plans - plans, including private - can be subsidized by the state if it is below a certain income level. Ultimately, it is a collaborative effort, we as a country we have entered an industrial activity, pollution Mess-based computer that is now cause or aggravate many diseases. Now it's our duty to care for others and left.
Tags: Asthma, Children, Likely, Minority, More, Texas
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