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    When a Child Has Asthma, the Family Suffers too

    A recent study that looked at how having a child with asthma affects families, found that the burden for some is substantial. Jonathan Finkelstein, MD, from the Department of Ambulatory Care and Prevention at Harvard Medical School, and his colleagues presented the results of their study at the 96th International Conference of the American Thoracic Society in Toronto.

    The child with asthma suffers not just as the result of symptoms, but because of missed school and activity limitations those symptoms often cause. In addition, many families find they're spending significant amounts of money while at the same time regularly missing work. This may decrease their income or even put their jobs in jeopardy. According to Dr. Finkelstein, "Clinicians should inquire about financial and other family impacts of children with asthma and help families identify available resources to cope with this chronic illness."

    The researchers mailed surveys to the parents of 2439 children with asthma aged five to 17, who were identified in three managed care organizations. The surveys examined the severity of disease as reported by the parents, out-of-pocket expenses during the previous month, missed work and decreased productivity (the "ability to get things done").

    Fifty-three percent of the parents that responded assessed their child's asthma as "mild", 40 percent felt their child's asthma was "moderate", and eight percent said their child had "severe" asthma.

    Researchers next looked at monthly out-of-pocket expenses incurred by families and compared those figures to asthma severity. Forty-six percent reported expenses of less than five dollars, 38 percent had expenses that ranged from five to 25 dollars, and 16 percent had expenses that exceeded 25 dollars per month. Parents of kids with moderate and severe asthma reported expenses in excess of 25 dollars per month 22 percent and 41 percent of the time, respectively.

    Missed work was another concern. Parents reported missing 0.5 days of work during the previous four weeks because of their child's illness. A total of 19 percent reported spending decreased amounts of time at work. And 19 percent felt they accomplished less than usual at work because of their child's asthma.

    Work wasn't the only area that suffered. Parents felt they were less able to get things done at home as well -- parents of 15 percent of kids with moderate asthma and 36 percent of kids with severe asthma, found this was a problem. Overall, family activities were limited sometimes or often in 22 percent of families, and in up to 52 percent of families that had a child with severe asthma in the home.

    Parents also reported that their child's asthma was at times a source of conflict in the home. Interestingly, however, Dr. Finkelstein noted that some of these same families also felt their child's asthma had brought their family closer together.
    Dr. Finkelstein pointed out that this study focused on families with medical insurance, stating, "We lack information about uninsured families". It's possible that families with fewer resources or those with only one parent in the home find it even harder to cope with their child's illness.

    Dr. Finkelstein concluded: "The critical question is if children get better care, will that effect the burden on families?"



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