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Biomedical subjects

Luz Claudio

Publications and source records attributed to Luz Claudio.

16 recordsLinked to original sources

Asthma and enrollment in special education among urban schoolchildren.

OBJECTIVES: We assessed whether asthma is associated with urban children's use of special education services. METHODS: We conducted a cross-sectional study in 24 randomly selected New York City public elementary schools using a parent-report questionnaire focusing on sociodemographic characteristics, special education enrollment, asthma diagnosis and symptoms, school absences, and use of health care services. RESULTS: Thirty-four percent of children enrolled in special education had been diagnosed with asthma, compared with 19% of children in the general student population. After control for sociodemographic factors, children with asthma were 60% more likely than children without asthma to be enrolled in special education (odds ratio [OR] = 1.62; 95% confidence interval [CI] = 1.22, 2.16). Asthmatic children in special education were significantly more likely to be from low-income families and to have been hospitalized in the previous 12 months than asthmatic children in general education. CONCLUSIONS: Inadequate asthma control may contribute to a greater risk of asthmatic children residing in urban areas being placed in special education. School health programs should consider targeting low-income urban children with asthma at risk for enrollment in special education through increased asthma interventions and medical support services.

Asthma↗

Disparities in the use of urgent health care services among asthmatic children.

BACKGROUND: Urgent care composes one third of the total costs associated with asthma. Asthmatic children of African American and Latino backgrounds have higher rates of emergency department (ED) use and hospitalizations than white children, especially in urban settings. OBJECTIVE: To evaluate the role of socioeconomic, disease-related, and access-to-care factors in utilization of the ED and inpatient services for urgent treatment of asthma. METHODS: A parent-response questionnaire was systematically distributed in public elementary schools that serve children of different socioeconomic backgrounds in New York City. RESULTS: The prevalence of current asthma was found to be 13.0% in 5- to 12-year-old children. Almost half of the current asthmatic patients had used urgent care in the ED or hospital in the previous 12 months. In univariate analysis, use of urgent care was strongly associated with race/ethnicity and income (P < .001). Adjusting for socioeconomic, disease-related, and access-to-care factors, including household income, symptom severity, type of health insurance, and usual source of asthma care, the racial/ethnic disparity persisted, with Latinos having 5 times the risk and African Americans having double the risk of using urgent care as whites. CONCLUSIONS: There is a failure in asthma management in this urban population, demonstrated by the finding that almost half of all current asthmatic patients used urgent care. After controlling for different socioeconomic and disease-related factors, minority race/ethnicity, low household income, and frequent evening symptoms were found to be strong predictors of urgent care utilization. Insurance status, delaying care for any reason, and use of controller medications were found not to be associated with urgent care use.

Black or African American↗

Prevalence of childhood asthma in urban communities: the impact of ethnicity and income.

PURPOSE: The goal of this study was to assess the relationship between hospitalization rates and asthma prevalence in New York City children and investigate the role that sociodemographic factors play in asthma. METHODS: A parent-report questionnaire was distributed in 26 randomly selected New York City public elementary schools, stratified according to neighborhood hospitalization rates. RESULTS: The overall student response rate was 76.9% (5250 students). Prevalence of current asthma was 17.9%, 9.59%, 6.39% (p < .001) in areas of high, median, and low asthma hospitalization rates, respectively. The overall prevalence of current asthma was 13.0%. Children living in predominantly low socioeconomic status (SES) communities had a 70% greater risk of current asthma, independent of their own ethnicity and income level. Asthma prevalence within different ethnic and income groups was consistently lower in neighborhoods of greater socioeconomic status, except among Puerto Rican children, who had high asthma prevalence, regardless of school attended or income. CONCLUSIONS: Prevalence of current asthma is strongly associated with attending a school in a low-income neighborhood. Although hospitalization rates have been used as an indicator of the burden of asthma in a neighborhood, it alone does not reflect the level of disparities that exist among communities with different socioeconomic backgrounds.

Asthma↗

Firefighter findings.

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Air Pollutants, Occupational↗

The health of Latino children: urgent priorities, unanswered questions, and a research agenda.

Latinos recently became the largest racial/ethnic minority group of US children. The Latino Consortium of the American Academy of Pediatrics Center for Child Health Research, consisting of 13 expert panelists, identified the most important urgent priorities and unanswered questions in Latino child health. Conclusions were drawn when consensus was reached among members, with refinement through multiple iterations. A consensus statement with supporting references was drafted and revised. This article summarizes the key issues, including lack of validated research instruments, frequent unjustified exclusion from studies, and failure to analyze data by pertinent subgroups. Latino children are at high risk for behavioral and developmental disorders, and there are many unanswered questions about their mental health needs and use of services. The prevalence of dental caries is disproportionately higher for Latino children, but the reasons for this disparity are unclear. Culture and language can profoundly affect Latino children's health, but not enough cultural competency training of health care professionals and provision of linguistically appropriate care occur. Latinos are underrepresented at every level of the health care professions. Latino children are at high risk for school dropout, environmental hazards, obesity, diabetes mellitus, asthma, lack of health insurance, nonfinancial barriers to health care access, and impaired quality of care, but many key questions in these areas remain unanswered. This article suggests areas in which more research is needed and ways to improve research and care of Latino children.

Asthma↗

Occupational health in Mexico.

This article describes the current situation of occupational health (OH) in Mexico, including socioeconomic context, legislation, health system, and educative and investigative resources, as well as the practice of OH. Workplace accidents per 100 workers decreased from 7.23 to 2.3 workers in 20 years; deaths decreased from 1.68 to 0.9 per 10,000 workers, while the occupational disease rate increased from 0.6 to 1 per 10,000 workers. This can be interpreted as an improvement in preventive measures as well as problems of recognition and registry. In Mexico OH faces challenges that range from needs for professional training and performance to needs for development of legal measures, coordination, information, and research.

Humans↗

Risk perception and communication regarding pesticide use in rural work: a case study in Rio de Janeiro State, Brazil.

In an agricultural region of Rio de Janeiro State, Brazil, rapid assessment procedures were used for risk-perception studies based on methodologic triangulation that included semi-structured interviews, participatory observations, and focus groups. Data were qualitatively categorized. Women's risk perception was prioritized, as they did not recognize some risks they were exposed to during work activities. To reach women likely to be exposed to pesticides, a photographic soap opera (fotonovela) was constructed in collaboration with rural workers, using community-based participatory research methods. Contents of the risk-communication strategies included the harmful effects of pesticides. Results showed that the inclusion of risk-perception studies in the development of educative and risk-communication campaigns is very important, bridging research to action.

Brazil↗