Multiple chronic conditions on the rise among children

Published Online: December 2014

In the US, 26% of youth manage a chronic condition and roughly 7% are now managing multiple chronic conditions (MCCs). MCCs have profound effects on cognitive, emotional, and social development, increasing expenditures for health care and disability programs, and put youth at substantially greater risk for decreased participation in the work force, educational opportunities, and quality of life. Asthma is the most common chronic condition of childhood, and is marked by significant disparities and health care expenditures. Now, in a study recently published in The Journal of Allergy and Clinical Immunology (JACI), Patel and colleagues present findings from a large, national study that reveals many youth with asthma actually manage MCCs.

Gathering data from the National Health Interview Survey, the authors of this study looked at estimates of MCC prevalence among 66,790 children and adolescents between the ages of 0-17 with and without asthma. Using weighted, complex survey techniques, analysis combines associations between having asthma and MCC with demographic characteristics and adverse asthma outcomes.

The authors found that 5% of children with asthma had one or more coexisting health conditions, and that the likelihood of having one or more chronic diseases or conditions was greater among those with asthma than those without. Those with asthma were twice as likely to have co-occurring high blood pressure and arthritis compared to those without asthma. Every additional chronic condition co-existing with asthma was associated with a greater likelihood of an asthma attack, emergency department visits, and missed school days.

This study shows that MCCs are evident in children and adolescents with asthma, and the subgroup of patients with co-occurring conditions with asthma appear to be vulnerable to adverse outcomes. Research efforts are warranted, as are counseling and education efforts to enable families to manage asthma in youth effectively—in conjunction with other chronic conditions. Clinical care teams may be aware of extra support resources that families may need to manage and coordinate the care of their children with asthma and MCC.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

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