The Philadelphia School District (PSD) recently sub-contracted 45 of its lowest performing schools to 7 private organizations, with Edison Inc. receiving responsibility for 21/45 schools. Since asthma is a well-known cause of absenteeism and poor academic performance (and many children are often undiagnosed), we compared the prevalence and severity of this disease between PSD and Edison schools.
We screened for asthma by using the ISAAC questionnaire, a self-administered and validated instrument that relies on videos depicting five asthma symptoms. Our target population comprised 6,727 middle schoolers from 65 Philadelphia public schools: 6006 managed by the PSD and 721 by Edison.
Overall, 23.7% of PSD children and 24.5% of Edison reported having asthma. When limiting analysis to students unaware of the diagnosis, schools managed by Edison had higher prevalence of at least one of three wheezy symptoms in the previous year (36.5% vs 32.3%, P=.05). They also had higher asthma severity scores, as indicated by the number of symptoms experienced in life (1.33 vs 1.16, P=.004), or in the previous year (.93 vs .79, P=.01), or more than once a month (.83 vs .60, P <.001).CONCLUSIONS: These data indicate a significantly higher prevalence of unrecognized asthma symptoms in the poorest-performing Philadelphia schools. They also support previous data from us, indicating a higher asthma prevalence in high-absentees from school (49.1 percent; N= 226) as compared to low-absentees (21.4 percent; N= 885), P<.001.
Although school management in Philadelphia was subcontracted to private companies based upon students academic performance, the prevalence of undiagnosed asthma and its severity might have played a role in this decision, by possibly contributing to absenteeism and poor academic performance. The identification and treatment of asthma in school-aged children is therefore critical to help students lead healthier and more successful lives.
S. Mangione, GlaxoSmithKline, grant monies; unrestricted educational grant provided by GSK to our AsthmaBUS program in Philadelphia schools.