health

The poorest kids have the highest rates of asthma and ADHD

W. Douglas Tynan, Ph.D., ABPP

Updated: Thursday, February 16, 2017, 8:22 AM

An overall increase in rates of asthma and attention deficit hyperactivity disorder affected the poorest families the most, found a Pediatrics study released online earlier this week.

Researchers also studied autism and found these rates also grew during the same period between 2003 and 2011, but did not appear to differ by socioeconomic group. That probably speaks to the genetic and neurological underpinnings of autism, and it appears that broad social factors do not affect the rate.

They found the asthma rate grew in all economic groups, but it went up much higher in our poorest families, with the rate now over 17 percent in the lowest income group. The same pattern held for ADHD, with over 12 percent in the lowest income group, higher than other families.

The increase seems quite striking for these medical conditions, but obvious to many families with children and those who care for them. A study published last month found that ADHD accounts for a large chunk of health care costs for children, and that asthma accounts for many emergency department visits. This new study, which is based on standard telephone interviews of families, also shows the relationship between poverty and these health problems.

As the authors note, poor children are exposed to violence, environmental toxins, poor nutrition, disrupted families, and frequent moves between homes and schools. The children diagnosed with ADHD often have other difficulties, including poor language development and problems regulating their moods. Children with asthma often have housing instability. The link between poverty and these disorders is real. Our task as community members, parents and health care providers is to determine how to prevent and treat these problems.

Children who have high-quality early education from infancy to kindergarten have far fewer behavior problems and better health, and do better cognitively and emotionally. The prevention strategy for ADHD and asthma should include skilled child care and effective, accessible parenting programs. For children with asthma, having a clearly identified primary care provider, who is educated about asthma and has a clear action plan of what to do in case of an episode, can go a long way to better management and fewer disruptions. For children with ADHD, access to good parenting programs and effective treatment in primary care is also essential. Finally, for children with autism, early screening and identification and early intervention are essential for good outcomes.

Based on clinical research of these disorders, we have the knowledge and tools to implement effective, efficient, family-centered interventions that cost far less than repeated emergency room visits or calls to agencies about a child’s behavior. What is needed now is an understanding by all of us that we need to care for the children in the community. When these health problems, arise we need to ask, what has happened to these children, and not blame the parents.

Are you a parent or caregiver? Here are a few recommendations:

All children should have a primary care provider, a pediatric or family practice, that you go to consistently and has your child’s records In Pennsylvania, all children can be covered by either Medicaid or CHIP insurance. Enroll your child if you haven’t already done so which provides access to routine primary care. If your child has asthma, ADHD, or any other health or mental health condition, consult your primary care office for guidance and help. Parenting is a set of skills that we can all learn. Many social service agencies in Philadelphia and Delaware County are here to help and offer good parenting programs or assistance for parents who may have question. Some of the programs offered include: Educating Communities for Parenting, Delaware County Family Center, Catholic Social Services- Philadelphia.

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W. Douglas Tynan, Ph.D., ABPP

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