To identify factors that may contribute to asthma morbidity, 214 households were surveyed in two Buffalo inner-city neighborhoods. Asthma was reported by 41 percent of households. Race, gender, and age of head of household were significantly associated with prevalence of asthma in a house. Caucasians and Latinos had a significantly higher rate of asthma compared with African Americans. All household triggers were significantly more likely to be present on the west than east side of Buffalo. Overall, smoking, pets, humidifier, and cockroaches were all significantly associated with asthma in the home. There was no significant difference in the treatment for asthma or the age or gender of asthmatics based on residential area. This study suggests that asthma prevalence in the inner city may be affected by multiple factors that must be taken account by policy makers and professionals designing interventions.

To determine the prevalence of caregiver-reported asthma in children 4 to 13 years old in metropolitan western New York State, surveys were conducted during 1997-1999 in the Buffalo, Niagara Falls, Iroquois, and Gowanda school systems. Questionnaires (3,889) were sent to the homes of elementary school children in nine schools in western New York. The caregivers were asked to complete a 13-item questionnaire for the child. Of the questionnaires, 60.5% (2,353/3,889) were completed.Of all children, 18% had physician-diagnosed asthma. Of children diagnosed with asthma, 86% were taking medication. Symptoms were consistent with suspected undiagnosed asthma for 13% of the children. Buffalo had the highest rate of diagnosed asthma (20%) for the age group. Gowanda had a prevalence of 18%, Iroquois 16%, and Niagara Falls 15%. Variations were observed in asthma prevalence rates among different racial/ ethnic groups. In general, boys had a significantly (P = .001) increased odds of being asthmatic compared with girls. Overall, African-Americans and Hispanic/Latino children had significantly (P = .012 and P = .005, respectively) higher asthma prevalence rates, two to five times those of their Caucasian peers. In Gowanda, the prevalence of diagnosed asthma among Native American children was 23%, compared to 15% among Caucasian children. Of diagnosed Native American children, 71% were female. In Gowanda, a significant association (P = .007) of asthma among children in split-grade classes was observed compared to nonsplit grades. Of Native American children in split grades, 60% were diagnosed asthmatics. These observations reveal a high prevalence of asthma in the age group of 4 to 13 year olds in western New York. Local variations in potential triggers of asthma need to be considered when advising asthmatics. The results suggest that some grades have a disproportionate amount of children with asthma. The implications of asthma for children's early education need to be examined further.The authors are from

This project investigated the feasibility and effectiveness of a school asthma program in reducing asthma exacerbations among school children. In 1997-1998, two schools were selected for a case control pilot study. The intervention required that students with asthma, who needed medication daily at school, must present a written plan from the health care provider. Students with asthma were identified through parent/guardian or school reports. The pilot program was expanded into five schools in 1998-1999. All schools kept records of rescue treatments for asthma episodes. The pilot intervention resulted in an 80% decrease in rescue treatments from 1996-1997 to 1997-1998. In the additional five schools, an overall decrease of 17% occurred in rescue treatments during 1998-2000. Overall, 65% of physicians provided requested Asthma Care Plans (ACP). In two schools, the number of asthma care plans that required anti-inflammatory medications tripled. Preliminary results indicate this school asthma program proved feasible and effective in reducing the frequency of asthma exacerbations at school.