Prevalence and consequences of asthma and wheezing in African-American and white adolescents

Purpose: To describe the functional consequences of health care utilization for wheezing symptoms and diagnosed asthma in a multiracial school-based population. Methods: Wheezing symptoms and physician-diagnosed asthma were measured in 2059 eighth graders with the International Study of Asthma and Allergies in Children video questionnaire. The sample site population was 40% African-American, 53% White, and 49% girls. Thirty-two percent of the children were on the free school lunch program. Adolescents self-reported their wheezing symptoms and physician diagnosis in response to the video wheezing scenes. They also answered questions on activity limitations, school attendance, and sleep disturbances owing to their wheezing symptoms. Multiple logistic regression was used to calculate odds ratios and adjust for potential confounders. Results: Nine percent of the adolescents reported physician-diagnosed asthma with current symptoms and 27% reported current wheezing with no diagnosis of asthma. Physician-diagnosed asthmatics and wheezers were 2.6 (95% confidence interval [CI] 1.9, 3.6) and 1.8 (95% CI 1.4, 2.2) times more likely, respectively, to miss school days because of wheezing symptoms than asymptomatic adolescents. Diagnosed asthmatics were 7.8 (95% CI 5.5, 11.2) times and wheezers 4.7 (95% CI 3.5, 6.1) times more likely to have sleep disturbances than asymptomatic adolescents. Diagnosed asthmatics were 49 (95% CI 30.0, 79.8) times and wheezers 4.8 (95% CI 3.0, 7.5) times as likely to report a clinic visit for wheezing than asymptomatic adolescents. African-Americans had similar prevalence of wheezing, compared with Whites, although African-Americans were 1.4 (95% CI 1.1, 1.9) times as likely to have physician-diagnosed asthma. Girls were twice as likely to report physician-diagnosed asthma and wheezing symptoms as were boys. Conclusions: Adolescents with wheezing experienced functional consequences comparable to those of adolescents with physician-diagnosed asthma. Although wheezers may have less severe asthma than diagnosed asthmatics, the functional consequences of wheezing are likely to impair school performance and limit activity. (C) Society for Adolescent Medicine, 2001.