Asthma in Rural Iowa Schoolchildren

Peter Thorne, Ph.D. and James Merchant, MD, Ph.D. DPH
University of Iowa
P01ES09607 and P30ES05606

Background: Studies on the prevalence of asthma in children in rural communities have produced conflicting results. While most people have a bucolic image of "life on the farm," there are many exposures and dangers that put children at risk for injury and illness. Exposures to dusts and molds from crops and animal feed stuffs have been implicated in children's respiratory disorders including asthma. To further address this issue, this team of NIEHS-supported researchers sought to estimate asthma prevalence and severity in farm and non-farm children.

Advance: The study population consisted of children aged 6-14 years enrolled in 10 school districts in two Iowa counties from 2000-2002. Children who lived on farms were only slightly less likely to have had ever had symptoms of asthma. The same was true for symptoms in the previous year. However, the small protective effect was only seen in one of the study counties. Farm and non-farm children that had experienced symptoms were equally as likely to have been given a diagnosis of asthma.

Implication: Asthma prevalence in these rural counties rivaled that seen in large Midwestern cities including Minneapolis and Chicago. The authors conclude that these findings do not support a protective effect of rural living for the development of asthma in children. To appropriately treat asthma, prompt diagnosis is critical. Less than half of children with frequent symptoms and three fourths with severe symptoms had ever been given a diagnosis of asthma. These findings and those of others suggest that underdiagnosis of asthma is common. When coupled with the high rate of frequent or severe symptoms among those given a diagnosis of asthma, the public health importance of effective rural models for asthma diagnosis and management is evident.

Citation: Chrischilles E, Ahrens R, Kuehl A, Kelly K, Thorne P, Burmeister L, Merchant J. Asthma prevalence and morbidity among rural Iowa schoolchildren. J Allergy Clin Immunol. 2004 Jan;113(1):66-71.