Running head: CHILDHOOD ASTHMA

Harry Ta

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Childhood Illness/Condition Report: Asthma

California State University, Long Beach

November 10, 2016

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Asthma is a lung condition in which the airways are inflamed and swollen, tightening and

obstructing the airways; thus, causing difficulty breathing (AAAAI, n.d.). Furthermore, the

airways will become more swollen when a person is exposed to an asthma trigger. Asthma

triggers can be dangerous and result in asthma attacks. During an asthma attack, the lung airways

will be constricted further and resulting in severe breathing difficulty (ACAAI, 2014). Some

common asthma triggers are tobacco smoke, dust mites, molds, stress, weather conditions, and

air pollution. The combination of genetic and environmental factors can lead to a child

developing asthma (Ober & Yao, 2011). When a child has a family history of asthma, and is

living in an environment where he or she is exposed to smoke, air pollution, and molds then that

child is a high risk for developing asthma.

There are signs and symptoms to identify if a child has asthma. Common signs of asthma

are reoccurring coughs, shortness of breath, and wheezing. Common symptoms of asthma are

difficulty breathing and chest tightness (ACAAI, 2014). There is no pathogen that causes asthma;

therefore, no modes of transmission. In addition, asthma is not contagious. Unfortunately, asthma

is a chronic condition with no cure (AAAAI, n.d.). However, there are treatments for children

with asthma so that children can better manage asthma conditions and improve quality of life.

Approximately 8.6% of children or 6.3 million children in the United States have asthma

and the mortality rate for children with asthma has increased by approximately 80% since 1980

(AAFA, 2015; asthmamd, n.d.). Asthma is also one of the leading chronic diseases in children

and is one of the leading causes of school absenteeism, responsible for more than 10.5 million

lost school days every year (Child Trends, 2015.). Asthma can and has harm childrens academic

career and grades. Without treatment and management, the rates will be much higher and impact

more childrens lives.

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There are many different rates for asthma among children depending on certain factors.

For example, gender. Asthma is also more prevalent among boys than girls with approximately

9% of boys reported having asthma, in comparison only 7% of girls reported having asthma

(Child Trends, 2015). According to asthma statistics and trends, there was an increase in child

asthma in the 1980s and 1990s, but child asthma has been slowly declining to a steady rate since

2000 overall, as well as for both males and females (Child Trends, 2015). There is no explanation

for more boys having asthma than girls, but one theory can be hormones. Other important

differences among asthma rates are by ethnicity, insurance coverage, and family income.

Asthma is more common among African American children than children from other

ethnicities. Asthma rates among African American children (14%) are followed by Hispanic

(8%), Caucasian (7%) and Asian children (8%) (Child Trends, 2015). An explanation for this

discrepancy may be the environment that each ethnicity lives in and genetics. African American

and Hispanic children are more likely to live in urban areas where air pollution is high than

Caucasian and Asian children. African American and Hispanic adults can also develop asthma in

urban areas and pass asthma to future children.

Type of insurance coverage is correlated with asthma rates among children. Compared to

children with private health insurance and uninsured children, children with public health

insurance have higher rates of asthma. Ten percent of children with public health insurance had

asthma in comparison to approximately seven percent of children with private health insurance

and children without health insurance (Child Trends, 2015). The reason for children with public

health insurance to have higher rates of asthma than children with no health insurance can be

parents want to have coverage over asthma care for their children, rather than no coverage.

Furthermore, the reason for children with public health insurance to have higher rates of asthma
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than children with private insurance can be that parents cannot afford private health insurance, so

parents choose the less expensive public health insurance.

Family income level can also determine asthma rates among children. Statistics indicates

that children with family incomes below the federal poverty level are at higher risk than children

with family incomes above the federal poverty level (Child Trends, 2015). This is a result of

genetics, environmental factors, and health services. These families with incomes below the

federal poverty level are more likely to live in urban areas where pollution is high. This

environment increases risk of asthma development in adults and children. Poor families also tend

to have lower rates of hospital and clinic visits due to expensive medical bills. The outcome of

this is lack of health services to manage asthma rates.

There is no cure for asthma, but there are treatments to manage asthma so that children

can have a better quality of life. There are two types of medicines that are taken with an inhaler:

quick-relief medicines and long-term control medicines. Short-acting inhaled beta2-agonists and

anticholinergics are quick-relief medicines that are taken for immediate relief when symptoms

appear (ACAAI, 2016). These two drugs are called bronchodilators and the purpose of the drugs

are to expand the airways to improve and enhance breathing. However, these two medicines do

not mitigate the inflammation of the airways. The inflammation of the lung passageways can be

reduced by using long-term control medicines. Long-term control medicines must be taken every

day to prevent symptoms and attacks, as well as help manage control over asthma (ACAAI,

2016). Some long-term control medicines are antileukotrienes, methylxanthines,

immunomodulators, cromolyn sodium and nedocromil.

Immunotherapy can also be used to treat asthma. Immunotherapy is often used for people

with allergies that triggers asthma. The two types of immunotherapy are allergy shots and
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sublingual tablets. Allergy shots have traces of allergens and are injected in the body to build

tolerance to the allergens. This method will reduce and can eliminate allergy symptoms (ACAAI,

2016). Sublingual tablets work in a similar fashion as allergy shots, but is dissolved under the

tongue rather than being injected into the skin. The immunotherapy, quick-relief and long-term

control medicines are all prescribed by an asthma specialist called an allergist.

To prevent asthma from developing in children and asthma attacks from occurring,

parents and children must be educated on in-doors and out-doors asthma triggers. Families must

to understand the importance of: cleaning the home especially the furniture to prevent dust,

dust mites, and mold from accumulating; the need to repair any damaged or leaking faucets and

pipes to avoid growths of mold; washing dishes and taking out the trash regularly; bathe pets

frequently; limiting exposure to tobacco; and keeping the household temperature around 70

degrees in order to prevent dust mites from thriving. Cleaning the home will help reduce the risk

of asthma developing and help manage asthma if a child already has asthma.

Creating an asthma management plan with a doctor and allergist is another option to

preventing asthma attacks and control asthma. There are four steps to the asthma management

plan that parents and children must take (AAFA, 2015). The first step is to know common

asthma triggers and limit exposure to them. Knowledge of asthma triggers and properly cleaning

the household to prevent and avoid asthma attacks is a good method to controlling asthma. The

second step is make sure children are taking their asthma medications properly and as prescribed

(AAFA, 2015). Children need to know the correct dosage of medication and when to use the

medication from their allergist to maintain a stable state. The third step of the asthma

management plan is children should monitor their asthma and recognize signs that symptoms

have worsen (AAFA, 2015). A peak flow meter can be used to detect any airways tightening
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hours before symptoms emerge when the child blows into the device. The last step of the asthma

management plan is informing the parents and children what to do when an asthma attack occurs

(AAFA, 2015).

There have been programs from the federal, state and community level to prevent and

treat asthma. At the federal level, the Asthmatic School-Childrens Treatment and Health

Management Act of 2004 have states require schools to allow students to self-administer

medication to treat a students asthma (CDC, 2016). A major intervention at the federal level was

made the Centers for Disease Control and Preventions (CDC) National Asthma Control

Program. The program has established a coordinated national public health response to control

asthma, build asthma control programs in 34 states, improve asthma surveillance, improve

asthma management in schools, inform state and local practitioners, and funded health

departments (CDC, 2013).

At the state level, many states have passed laws that require schools to allow students to

bring asthma medication and self-administer the medication. For example, the California

Education Code 49422-49427. States such as Hawaii have developed programs to increase

asthma awareness, improve asthma surveillance, as well as expand and improve health services

to treat asthma among children and adults in the states (Hawaii State Department of Health). At

the community level, programs developed by hospitals such as the Community Asthma

Prevention Program (CAPP) offers free asthma education classes in schools and community

centers in Philadelphia (Childrens Hospital of Philadelphia, n.d.). Another example of

community interventions for children with asthma is the Community Asthma Program (CAP)

developed by the Baltimore City Health Department. CAP provides community health workers
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to improve asthma control for children by conducting home visits to educate families (Baltimore

City Health Department, n.d.).

In a school setting, teachers can improve classroom environment so that students with

asthma can learn, grow and participate in class activities. The teachers must know which kid has

asthma in his or her classroom. For physical activities, teachers and coaches need to adjust

exercises so that students with asthma will get proper exercises without triggering an asthma

attack. For instance, alternate walking and running, and have occasional breaks to allow asthma

students to catch his or her breath. Coaches and teachers need to remind students to take

medications before and after physical activities in required to. Coaches and teachers also have to

be attentive to the weather and environment when playing outside so that no asthma episodes

will occur.

Educators need to learn about asthma triggers, in addition to how to detect signs and

symptoms of an asthma attack. Teachers have to develop a plan with students with asthma in

case schoolwork is not finished due to asthma (AIM, n.d.). The educators also have to know side

effects of asthma medications and report to the school nurse any student expressing side effects.

Teachers have to cautious and aware of chemicals, pens, glues, and other classroom materials in

use as those materials can trigger asthma attacks (AIM, n.d.). Finally, teachers should educate the

classroom on asthma to increase understanding for students that do have asthma, and so that

other classmates know when to call for help when a student is experiencing an asthma attack.

With this knowledge, teachers can provide an environment that is suitable for asthma students to

develop.
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References

AAFA. (2015, September). Retrieved November 10, 2016, from

http://www.aafa.org/page/asthma-prevention.aspx
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AAFA. (2015, August). Retrieved November 10, 2016, from http://www.aafa.org/page/asthma-

facts.aspx

Asthma. (n.d.). Retrieved November 10, 2016, from http://health.baltimorecity.gov/node/454

Asthma - Child Trends. (2015, March). Retrieved November 10, 2016, from

http://www.childtrends.org/indicators/asthma/

Asthma Attack. (n.d.). Retrieved November 9, 2016, from

http://acaai.org/asthma/symptoms/asthma-attack

Asthma in Schools: The Basics for Parents. (n.d.). Retrieved November 10, 2016, from

http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/asthma/living-with-

asthma/creating-asthma-friendly-environments/asthma-in-schools.html

Asthma Statistics | AsthmaMD. (n.d.). Retrieved November 10, 2016, from

http://asthmamd.org/asthma-statistics/

Asthma Treatment. (2016). Retrieved November 10, 2016, from http://acaai.org/asthma/asthma-

treatment

Asthma | AAAAI. (n.d.). Retrieved November 10, 2016, from http://www.aaaai.org/conditions-

and-treatments/asthma

Asthma Chronic Disease Prevention & Health Promotion Division. (n.d.). Retrieved November

10, 2016, from http://health.hawaii.gov/asthma/home/hawaii-asthma-control-program/

CDCs National Asthma Control Program: An Investment in America's Health. (2013).

Retrieved November 10, 2016, from

http://www.cdc.gov/asthma/pdfs/investment_americas_health.pdf

Common Asthma Triggers. (2012). Retrieved November 10, 2016, from

http://www.cdc.gov/asthma/triggers.html
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Community Asthma Prevention Program (CAPP) | Children's ... (n.d.). Retrieved November 10,

2016, from http://www.chop.edu/centers-programs/community-asthma-prevention-

program-capp