NIH News Advisory
National Institute of Allergy and
Infectious Diseases

Wednesday, Feb. 19, 1997

James Hadley
(301) 402-1663

NIAID Inner-City Asthma Study Finds Multiple Factors
Lead to Increased Asthma Morbidity

In the largest asthma study ever completed of children in the inner city, researchers supported by the National Institute of Allergy and Infectious Diseases (NIAID) found a wide variety of factors, rather than one single cause, responsible for the dramatic increase in asthma morbidity.

Asthma has been increasing in the United States over several decades. This increase is most apparent among children, especially those living in the inner city. Approximately 15 million Americans suffer from asthma. Annually, in the United States, about 500,000 asthma-related hospitalizations occur and 5,000 people die.

NIAID recently completed the first five-year phase of its National Cooperative Inner-City Asthma Study with more than 1,500 children, ages 4 to 11, living in inner cities. Nearly 75 percent of these children were African-Americans and 20 percent were Hispanic.

The researchers found that asthma morbidity was related to environmental exposures, such as indoor allergens and passive cigarette smoke, to psychological problems of both the children and their caretakers, and to problems with access to medical care and appropriate medications. In the study, asthma was more severe in the approximately 50 percent of the patients who reported significant barriers to access to medical care.

Families in inner cities face a wide variety of problems related to poor housing, lack of insurance, and to difficulties in accessing medical care and referrals to smoking cessation programs, among other issues. In view of the study findings, scientists developed a broad-based intervention centered around the use of an asthma counselor, who was a trained social worker. The counselor did not provide medical care or interact with the patient's physician, but instituted educational, behavioral and environmental interventions tailored to the specific needs of individual children and their families. These efforts resulted in significant reductions in symptoms and doctor visits for asthma.

Researchers will discuss details of the study at the American Academy of Allergy Asthma and Immunology meeting on Saturday, February 22, from 2:15 p.m. to 4:45 p.m. in the Moscone Convention Center in San Francisco.

The moderators of the session on inner-city asthma are Daniel Rotrosen, M.D., chief of the Asthma, Allergy and Inflammation Branch and Ernestine T. Smartt, R.N., director of the Office of Epidemiology and Clinical Trials in NIAID's Division of Allergy, Immunology and Transplantation.

Panelists include: H. James Wedner, M.D., Washington University, in St. Louis, Mo.; Richard Evans, III, M.D., M.Ph., Children's Memorial Hospital in Chicago, Ill.; Peyton Eggleston, M.D., Johns Hopkins University in Baltimore, Md.; and Herman Mitchell, Ph.D., New England Research Institute in Watertown, Mass.

NIAID, a component of the National Institutes of Health (NIH), conducts and supports research to prevent, diagnose and treat illnesses such as AIDS and other sexually transmitted diseases, tuberculosis, asthma and allergies. NIH is an agency of the U.S. Department of Health and Human Services.

NIAID press releases, fact sheets and other materials are available on the Internet via the NIAID home page at