ABSTRACT
BACKGROUND: To explore the association between obesity and asthma in US children and adolescents with adjustment of other structural and behavioral factors. METHOD: Prevalence and associated risk factors of asthma were explored in 102,273 children and adolescents in the National Survey of Children's Health (2003-2004). Subgroup analysis was performed for subjects of 0-6 year-old, 7-12 year-old, and 13-17 year-old. Crude and adjusted odds ratios for the potential risk factors were examined in univariate and multivariate logistic regressions. RESULTS: The overall prevalence of obesity was 24.5% and that of asthma was 12.5%. The adjusted odds ratio of asthma with obesity remains significantly bigger than 1 for children in the 7-12 and the 13-17 year-old age-groups. Gender and race were significantly associated with asthma in all age groups. The two parent family structure showed significant protectiveness against asthma with children in the 0-6 year-old age group. Poverty was positively associated with asthma in the 7-12 years old age group. Having a smoker in the household increased the odds of asthma by 29% and 23.5% in the 0-6 and 13-17 year-old age-groups, respectively. Higher education level of the parents and access to healthcare showed positive association with asthma in the 13-17 year-old age group. CONCLUSION: Gender and race were significantly associated with asthma. In the 13-17 year-old age-groups, obesity, household education level, healthcare coverage, and household smoking were positively associated with asthma. Further studies should characterize how the family structure and household education level influence childhood asthma in 0-6 and 13-17 year-old age-groups respectively.
Subject(s)
Asthma/complications , Asthma/epidemiology , Health Surveys , Obesity/complications , Obesity/epidemiology , Adolescent , Aging/physiology , Child , Child, Preschool , Female , Health Services Accessibility/statistics & numerical data , Humans , Infant , Insurance Coverage/statistics & numerical data , Logistic Models , Male , Odds Ratio , Parents/education , Poverty/statistics & numerical data , Racial Groups/statistics & numerical data , Risk Factors , Sex Characteristics , Single-Parent Family/statistics & numerical data , Tobacco Smoke Pollution/adverse effects , Tobacco Smoke Pollution/statistics & numerical data , United States/epidemiologyABSTRACT
This column describes the first year of efforts in New Mexico to reform the behavioral health system. The process, guided by principles of cultural exchange theory, seeks to establish a "collaborative culture" among all stakeholders involved, including state agencies, consumers, families, advocates, and providers. Challenges have included inadequate system funding; insufficient development of skill sets among state personnel; underestimation of time and labor needed to address complex tasks; varying federal statutory and funder requirements for individual agencies; lack of a solid infrastructure for data collection, management, and dissemination; and clear definitions of the roles and relationships of local stakeholders to the state leadership group.