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Asthma and Poverty

Asthma is the most common chronic childhood disease in the United States, currently affecting an estimated 7 million children below 18 years of age. It is more prevalent and has greater impact within families living in poverty. The purpose of this study was to gain in-depth, qualitative understanding of asthma in families living in poverty. Data were derived from a larger study, 5R01-054961-03. The conceptual framework that guided this study was selfmanagement. The setting was a large urban county in the Midwest, and participants were 41 women recruited using targeted chain referral sampling. Instruments were a semistructured interview guide and the HANES General Well-Being Schedule. A longitudinal narrative interview design was used. Women were interviewed 4 times over the course of a year; data gathered included information about the health of each mother and her children. Interviews were audio recorded, transcribed verbatim, and entered into NVIVO software for data management. Multistage narrative analysis and descriptive statistics were used to analyze the data. Findings indicated that 19 participants (46%) had children with “breathing problems,” and 37% of the mothers specifically identified these problems as asthma. The children’s asthma had an impact on the mother’s ability to maintain consistent employment and the children’s school performance. Other barriers included financial and emotional stress, stress related to neighborhood safety, and lack of knowledge about asthma management that contributed to poor control of the children’s asthma symptoms. Implications for practice are as follows: Because children spend a large portion of their day in a school setting, school nurses are in a unique position to work collaboratively with the children, teachers, and parents to improve asthma management and ease the burden of asthma on families in poverty. Further research is needed to study interventions targeted to improve asthma management among children in poverty.