Asthma - Children in Arkansas

Arkansas

Asthma is a serious chronic disease that affects the lungs and commonly causes wheezing, difficulty breathing and coughing. However, not everyone who has asthma has these symptoms and having these symptoms doesn't always mean someone has asthma. Although deaths due to asthma are relatively rare and generally preventable, asthma can be life-threatening if not properly treated. 

There are many risk factors for childhood asthma, including:

• Having allergies or a family history of allergies.
• Getting frequent respiratory infections.
• Having a low birth weight. 
• Being exposed to secondhand smoke.
• Growing up in a low-income environment.
• Living in areas with high levels of air pollution.

Childhood asthma also has negative educational and economic impacts. Children with asthma miss an additional 2.3 days of school per year on average compared with their peers without asthma. A 2015 study estimated the annual costs of pediatric asthma in the U.S. at $5.92 billion.

According to data from the National Survey of Children’s Health, the prevalence of childhood asthma is higher among: 

• Boys compared with girls.
• Children age 6 and older compared with children ages 0-5.
• Black children compared with Hispanic, white and Asian children.
• Children living below the federal poverty level compared with children from higher-income households.

A 2022 study found that long-term exposure to nitrogen dioxide from gas and propane stoves is likely responsible for approximately 50,000 current cases of pediatric asthma in the United States.

A doctor can determine if a child has asthma by asking questions about their breathing and family history. To assess how well the child’s lungs are working, they may also perform a spirometry test. This is a simple, non-invasive test that involves the child blowing into a device. Asthma can be controlled by avoiding asthma triggers and following a doctor’s advice. Common asthma triggers include tobacco smoke, dust mites, outdoor air pollution, pets and mold. Other interventions like home visits and school-centered asthma programs can help improve asthma complications in children and reduce costs for families. 

Strategies to help your child manage asthma include:

• Scheduling regular well-child visits and discussing questions and concerns about asthma with your pediatrician. 
• Developing a written asthma action plan to manage symptoms and emergency situations.
• Watching for signs, such as frequent symptom flares or asthma attacks, that suggest your child may need a change in treatment. 
• Controlling dust and mold within the home, especially in your child’s bedroom. This may involve regular vacuuming and washing blankets. 
• Minimizing your child’s exposure to secondhand smoke and vaping.
• Encouraging regular physical activity, which has been shown to improve fitness and asthma symptoms in children. 

The Community Preventive Services Task Force recommends school-based asthma self-management education to reduce hospitalizations and emergency room visits among children with asthma. The American Lung Association’s Open Airways for Schools program aims to educate children ages 8-11 about asthma self-management. Through interactive activities, the program teaches children with asthma to recognize warning signs (shortness of breath, chest tightness, etc.), avoid triggers and make informed decisions about their health.

County Health Rankings & Roadmaps has found that having a professional perform a healthy home environment assessment reduces exposure to allergens, improves air quality and leads to better self-management of asthma. While healthy home assessments can significantly reduce health care costs by preventing urgent care visits and hospitalizations, insurance coverage for these services can vary. Families should check with their health insurance plan to see if an assessment is a covered benefit.

Healthy People 2030 has multiple objectives related to asthma, including:

• Reducing emergency department visits for children younger than 5 years with asthma.
• Reducing emergency department visits for people age 5 and older with asthma.
• Reducing hospitalizations for asthma in children younger than 5 years.
• Reducing hospitalizations for asthma in people ages 5-64.

Kashtan, Yannai, Metta Nicholson, Colin J. Finnegan, Zutao Ouyang, Anchal Garg, Eric D. Lebel, Sebastian T. Rowland, et al. “Nitrogen Dioxide Exposure, Health Outcomes, and Associated Demographic Disparities Due to Gas and Propane Combustion by U.S. Stoves.” Science Advances 10, no. 18 (May 3, 2024): eadm8680. https://doi.org/10.1126/sciadv.adm8680.

Liptzin, Deborah R., Melanie C. Gleason, Lisa C. Cicutto, Chris L. Cleveland, Donna J. Shocks, Martha K. White, Anna V. Faino, and Stanley J. Szefler. “Developing, Implementing, and Evaluating a School-Centered Asthma Program: Step-Up Asthma Program.” The Journal of Allergy and Clinical Immunology: In Practice 4, no. 5 (September 2016): 972-979.e1. https://doi.org/10.1016/j.jaip.2016.04.016.

Lu, Kim D., and Erick Forno. “Exercise and Lifestyle Changes in Pediatric Asthma.” Current Opinion in Pulmonary Medicine 26, no. 1 (January 2020): 103–11. https://doi.org/10.1097/MCP.0000000000000636.

Marshall, Erica T., Jing Guo, Elizabeth Flood, Megan T. Sandel, Matthew D. Sadof, and Jean M. Zotter. “Home Visits for Children With Asthma Reduce Medicaid Costs.” Preventing Chronic Disease 17 (2020). https://doi.org/10.5888/pcd17.190288.

Nurmagambetov, Tursynbek, Robin Kuwahara, and Paul Garbe. “The Economic Burden of Asthma in the United States, 2008–2013.” Annals of the American Thoracic Society 15, no. 3 (March 2018): 348–56. https://doi.org/10.1513/AnnalsATS.201703-259OC.

Sullivan, Patrick W., Vahram Ghushchyan, Prakash Navaratnam, Howard S. Friedman, Abhishek Kavati, Benjamin Ortiz, and Bob Lanier. “The National Cost of Asthma among School-Aged Children in the United States.” Annals of Allergy, Asthma & Immunology 119, no. 3 (September 2017): 246-252.e1.https://doi.org/10.1016/j.anai.2017.07.002.