High Asthma Rates a Mystery

In two thousand one, twelve point seven percent of adults in New England had been diagnosed with asthma.

Now, it’s fifteen percent, according to a study by the Asthma Regional Council.

Stillman: Everybody wants to know, why is this happening.

Laurie Stillman is the Council’s Executive Director.

Stillman: The problem with asthma is we don’t know what’s causing the disease. We know what can exacerbate and can trigger asthma attacks, but we don’t know what’s causing it.

Nor is it clear why asthma is more prevalent in New England than in other regions of the country.

It’s more common than in the mid Atlantic, which has more factors associated with asthma.

Like, more urban centers, greater poverty, and a larger black and Hispanic population.

Alice Bruning, of the Department of Health and Human Services, says high asthma rates are probably due—at least in part—to poor air quality.

Bruning: We are downwind, and there’s been a great deal of talk over the last few years about the air pollution issues in NH that are caused from airflow coming from the Midwest, power plants, etcetera.

Depending on where the wind and weather are coming from, New Hampshire’s air quality can be the worst in the country.

But at other times, the air can be some of the cleanest.

This inconsistency makes it hard to parse out just how much outdoor air is responsible for asthma rates.

Bruning says poor indoor air quality could also factor.

Bruning: People in New England spend more time indoors, than people perhaps in warmer climates. So when you get less air flow through a household then things like dust mites, cockroaches, environmental tobacco smoke, all of these things are going to concentrate even more.

And according to the Centers for Disease Control, New Hampshire leads the region in adult smoking rates.

Dr. David Goodman, a pediatric pulmonologist, notes that asthma is one of the most common chronic diseases among children.

He posits that higher asthma rates could reflect better detection.

Goodman: I think it’s true that the awareness of asthma by practitioners, particularly by primary care physicians in Northern New England has substantially increased over the 17 years that I’ve been at Dartmouth Hitchcock. It was fairly common 15 years ago to see patients who had chest symptoms, for even a fairly prolonged period of time, and it hadn’t been diagnosed as asthma. That’s much less the case now.

But even with improved asthma detection, and effective methods available for keeping symptoms under control, asthmatics still suffer.

According to the Asthma Regional Council’s report, New England children missed sixty three percent more days of school than children without asthma.

About a third of asthmatic adults reported limitations on their activity.

Diane Smoger at the American Lung Association says these health problems are avoidable.

Smoger: We should be able to prevent anyone from dying from this disease. And prevent anyone from having a lousy night of sleep or from coughing unnecessarily. We want people to live healthy, normal lives. And we know right now people are not living a healthy, normal life.

And this is evident in emergency room visits.

In 2000 asthmatic patients visited the ER in New Hampshire nearly seven thousand times.

According the Manchester Health Department the statewide cost of not preventing these visits was three point three million dollars.

New Hampshire’s Health and Human Services Department has received a grant from the CDC to tackle asthma.

The Asthma Control Program is working on getting schools to use less toxic cleaning products, helping builders design better-ventilated homes, and making sure health care providers adhere to the best treatment practices.

Laurie Stillman from the Asthma Regional Council says the situation seems ironic.

Stillman: The New England states are probably doing as a region almost more to tackle asthma than any other region. So who knows. Maybe the asthma epidemic would be worse if we weren’t doing what we’re doing.

SOQ