School Based Pediatric Asthma Surveillance in Massachusetts

Abstract

Asthma remains one of the most common chronic diseases among children in the United States today. Surveillance is limited to national and state estimates which can vary over time and by population (CDC/NCHS, National Health Interview Survey, 2012). It is estimated that anywhere from 14% to 50% of children with asthma remain undiagnosed. The Massachusetts Department of Public Health's Bureau of Environmental Health (MDPH/BEH) has been conducting a successful and comprehensive statewide school-based asthma surveillance program since 2002. Partnering with school nurses throughout the state, we request aggregate information via a one-page survey. The survey is distributed to all public, private, charter and virtual schools in Massachusetts (n=1800). Variables collected include number of students with asthma by gender, grade (K-8), race/ethnicity and community of residence. Therefore, we can estimate prevalence by school and community. Now entering the 15th year, the program has a near 100% survey response rate. This successful surveillance effort reveals a statewide asthma prevalence of 12.4%, one of the highest rates in the nation and suggests approximately 85,000 students in Massachusetts carry the diagnosis. Furthermore, trends over the last 10 years of data collection indicate asthma to be higher among males than females for this age group (~5-14). School-based pediatric asthma surveillance demonstrates the important role school nurses play in surveillance. The feasibility of using school health records as a secondary data source will be highlighted as a reliable, aggregate, community-based source of data.