Abstract
Objective
To examine the role of higher long-term poverty rates in the Maritimes as an explanation for higher rates of asthma among children 2–7 years of age.
Methods
Using longitudinal data from the National Longitudinal Survey of Children and Youth (NLSCY), logistic regressions examine associations between poverty duration and the probability of a child having been diagnosed with asthma, having a current asthma attack or experiencing wheezing in the past 12 months, controlling for other known determinants.
Results
NLSCY data indicate that 15.9% of Maritime children have been diagnosed with asthma, 8.7% have recently had an attack and 24.1% experienced wheezing, statistically higher levels than in the rest of Canada. Children in chronic poverty show rates that are over 30% higher than the Canadian averages. Although 19.9% of Maritime children have been chronically poor compared to 11.7% elsewhere, and although poverty is associated with a higher probability of asthma/wheezing, controlling for poverty status does not eliminate the regional difference in asthma rates. Including other controls with poverty status again does not fully explain the difference.
Conclusion
While these findings do not completely explain why asthma prevalence rates are higher for Maritime children, they do indicate important pathways from poverty to childhood asthma. For example, chronically poor children are more likely to have had low birthweights and are less likely to have been breastfed, both of which are correlates of asthma. Such information can be useful for policy-makers. Pollutants and other environmental factors associated with asthma not included in the study may help further explain regional differences.
MeSH terms: asthma, child, poverty, socio-economic factors
Réumé
Objectif
Examiner les liens possibles entre les taux élevés de pauvreté durable dans les Maritimes et les taux d’asthme élevés chez les enfants de deux à sept ans.
Méthode
à l’aide des données de l’Enquête longitudinale nationale sur les enfants et les jeunes, et après avoir apporté des ajustements pour tenir compte des effets d’autres déterminants connus, nous avons analysé par régression logistique le lien entre la durée de la pauvreté et la probabilité qu’un enfant ait reçu un diagnostic d’asthme, fasse actuellement des crises d’asthme ou ait éprouvé des symptômes de respiration sifflante au cours des 12 mois précédents.
Résultats
Selon les données de l’Enquête, 15,9% des enfants des Maritimes avaient reçu un diagnostic d’asthme, 8,7% avaient eu une crise d’asthme récemment, et 24,1% avaient eu des symptômes de respiration sifflante. Ces niveaux étaient proportionnellement plus élevés que dans le reste du Canada. Les enfants vivant sous le seuil de pauvreté de façon chronique affichaient des taux de plus de 30% supérieurs à la moyenne canadienne. Bien que 19,9% des enfants des Maritimes aient vécu une pauvreté chronique (contre 11,7% ailleurs au Canada), et bien que la pauvreté soit associée à une probabilité accrue d’asthme ou de respiration sifflante, l’écart régional dans les taux d’asthme ne disparaît pas, même après avoir apporté des ajustements pour tenir compte des effets de la pauvreté. L’ajout d’autres déterminants que la pauvreté n’explique pas non plus entièrement l’écart constaté.
Conclusion
Nos résultats n’expliquent pas entièrement la raison des taux supérieurs de prévalence de l’asthme chez les enfants des Maritimes, mais ils jettent un éclairage intéressant sur la progression de la pauvreté à l’asthme chez les enfants. Par exemple, les enfants qui vivent dans un état de pauvreté chronique sont plus susceptibles d’avoir eu un poids insuffisant à la naissance et moins susceptibles d’avoir été allaités, deux facteurs corrélés avec l’asthme. Ces renseignements peuvent être utiles aux décideurs. Les polluants et d’autres facteurs environnementaux associés à l’asthme dont la présente étude n’a pas tenu compte pourraient aussi expliquer une partie de l’écart régional.
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