Asthma and Behavior in Homeless 4- to 7-Year-Olds

Cutuli, J. J.; Herbers, Janette E.; Rinaldi, Maria Michela; Masten, Ann S.; Oberg, Charles N.

doi:10.1542/peds.2009-0103

Cited by 37 publications

(38 citation statements)

References 39 publications

(43 reference statements)

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“…Homeless children experience health problems secondary to the stress and risks associated with episodic and chronic homelessness: acute illness, such as colds and diarrheal illnesses, and chronic illness such as iron deficiency anemia, obesity, asthma and mental health [3,4]. Asthma is common in homeless children with a prevalence of 28-40% compared with 8% in all children [4][5][6]. Sheltered homeless children have elevated rates of asthma-associated emergency room visits (28%) and hospitalizations (24%) [5] and are less likely to have a usual source of medical care [7,8].…”

Section: Introductionmentioning

confidence: 99%

Asthma, tobacco smoke and the indoor environment: a qualitative study of sheltered homeless families

et al. 2013

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Section: Introductionmentioning

confidence: 99%

Asthma, tobacco smoke and the indoor environment: a qualitative study of sheltered homeless families

et al. 2013

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“…As of 2016, 1.7 million internally displaced persons were living in camps and collective centres, including shelters (2). Studies have shown that poor shelter or dwelling conditions (such as overcrowding, lack of basic resources, and poor sanitation) may lead to deteriorations in health (3)(4)(5)(6). For example, in the aftermath of the Great East Japan Earthquake and tsunami in 2011, the prevalence of asthma, exacerbations of chronic obstructive pulmonary disease (COPD), and community-acquired pneumonia were two to three times greater compared to the previous year, with half of the community-acquired pneumonia cases originating in evacuation shelters (6).…”

Section: Introductionmentioning

confidence: 99%

“…For example, in the aftermath of the Great East Japan Earthquake and tsunami in 2011, the prevalence of asthma, exacerbations of chronic obstructive pulmonary disease (COPD), and community-acquired pneumonia were two to three times greater compared to the previous year, with half of the community-acquired pneumonia cases originating in evacuation shelters (6). Individuals with asthma may be more susceptible to compromised living conditions and stress leading to a higher risk of asthma exacerbations and other complications (3)(4)(5)(6). It is important to identify uncontrolled asthmatics and those who are underdiagnosed or at-risk of developing asthma in order to target preventive strategies and asthma management to minimize the deterioration of asthma control.…”

Section: Introductionmentioning

confidence: 99%

Uncontrolled and under-diagnosed asthma in a Damascus shelter during the Syrian crisis

et al. 2017

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Background: Studies have shown that poor shelter or dwelling conditions may lead to deteriorations in health. Those with asthma may be more susceptible to compromised living conditions and stress leading to a higher risk of asthma exacerbations. To describe the asthma control and quality of life of individuals with diagnosed asthma living in a shelter in Damascus, Syria and estimate the prevalence of respiratory symptoms in shelter dwellers without diagnosed asthma. Methods:In this cross-sectional study, all individuals 5 years and older living in Al-Herjalleh shelter with diagnosed asthma were recruited to complete a questionnaire, which included items related to their respiratory symptoms, asthma exacerbations, exposure to asthma triggers, medication use, and health-related quality of life before and since entering the shelter. A representative sample of shelter dwellers without diagnosed asthma also completed a questionnaire to establish their demographics, respiratory symptoms, environment and chronic disease co-morbidities, in order to identify factors associated with under-diagnosed asthma. All participants underwent spirometry to measure their lung function. Descriptive statistics were calculated, and chi-square tests and Student's t-tests were used to compare individuals with asthma before and since entering the shelter, as well as to compare those with under-diagnosed asthma and individuals without asthma.Results: The prevalence of asthma at the Al-Herjalleh shelter in those aged 5 years and older was approximately 8.5%. Nearly 70% of the asthma group felt their asthma had worsened since entering the shelter, and there was a significant drop in the proportion of individuals using inhaled corticosteroids (ICS), with only 4.3% using daily ICS in the shelter (P<0.0001). The proportion of individuals experiencing a severe asthma attack did not change after entering the shelter (P=0.97), but almost all individuals with asthma (94.4%) reported worsening in their health-related quality of life. In the non-asthma group, 44.2% of participants reported episodes of wheezing, coughing and breathlessness at night, consistent with underdiagnosed asthma. A higher proportion of those with under-diagnosed asthma had allergic rhinitis (57.1%), symptoms of post-traumatic stress disorder (PTSD) (35.1%), and abnormal spirometry (60.0%), compared to those without asthma. Conclusions:The findings of our study highlight the need for asthma programs in Syrian shelters as significant gaps exist in both the screening and management of chronic respiratory diseases to minimize asthma deterioration in Syrian shelter dwellers.

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“…19 Asthma has been reported at three times the national average in pediatric homeless patients. 20 One study looking at homeless children in New York City estimated the rate of asthma to be 31.5%. 21 Our study had 8 patients who were seen at the homeless clinic who had asthma (10.7%) and 15 patients with asthma and allergies (20.0%).…”

Section: Atopic Dermatitis Asthma and The Homelessmentioning

confidence: 99%

Skin disorders encountered at a pediatric homeless clinic: A retrospective chart review

2016

Journal of the American Academy of Dermatology

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BACKGROUND AND SIGNIFICANCE:Limited information about skin problems in homeless children exists in the current literature. RESEARCH QUESTION:Our objective was to classify the types of skin conditions commonly seen in a pediatric homeless clinic as compared to that of a large tertiary care children's hospital dermatology clinic. METHODS:We conducted a retrospective cohort study of all children treated by pediatric dermatologists at a homeless clinic, and compared the diagnoses to what was seen at a general pediatric dermatology clinic. RESULTS:There were 100 visits for 75 patients at the homeless clinic during the study period of 33 months. Within the homeless clinic visits, 62% of patient's reported living in a shelter. In the homeless population the most common diagnoses were atopic dermatitis (31.0%), acne (27.0%), other dermatitis (7.0%), molluscum (6.0%), warts (5.0%) and nevi (4.0%). In the nonhomeless population, the most common diagnoses were atopic dermatitis (19.2%), contact dermatitis (9.7%), hemangioma (9.5%), acne (9.4%), nevus, non-neoplastic (6.8%) and benign neoplasm of the skin (6.3%). CONCLUSION:Homeless and non-homeless children suffer from similar conditions such as atopic dermatitis, acne and nevi. With the growing homeless pediatric population and their exposure to unsheltered environments, further studies are needed to investigate the skin conditions affecting this population.

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Asthma and Behavior in Homeless 4- to 7-Year-Olds

Cited by 37 publications

References 39 publications

Asthma, tobacco smoke and the indoor environment: a qualitative study of sheltered homeless families

Asthma, tobacco smoke and the indoor environment: a qualitative study of sheltered homeless families

Uncontrolled and under-diagnosed asthma in a Damascus shelter during the Syrian crisis

Skin disorders encountered at a pediatric homeless clinic: A retrospective chart review

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