Study Finds a Rising Trend of Co-Morbid Chronic Conditions Among Poor Children

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A new analysis of children’s health found a disturbing national trend in prevalence of co-morbid chronic conditions among poor children with asthma, autism, and attention deficit hyperactivity disorder.

A new analysis of children’s health found a disturbing national trend in prevalence of co-morbid chronic conditions among poor children with asthma, autism and attention deficit hyperactivity disorder.

The percentage of children with chronic health conditions is on the rise. Many children experience more than one chronic medical problem and it is an especially common trend among children who live in or near poverty. Christian D. Pulcini, MD, MEd, MPH, conducted the analysis to evaluate the trends in prevalence and co-morbidities for 3 common conditions: asthma, attention deficit/hyperactivity disorder (ADHD), and autism. These 3 conditions were chosen because they have important policy implications for both pediatrics and government programs such as the Supplemental Security Income program. The findings of the study were presented at the Pediatric Academic Societies 2016 Meeting.

For the study, Pulcini and fellow researchers conducted secondary analyses of the National Survey of Children's Health for years 2003, 2007, and 2011/12. By studying through the years and the sociodemographic characteristics, the researchers identified trends in asthma, ADHD, and autism. Furthermore, trends in co-morbidities among children with each of these conditions were studied.


It was found that compared to non-poor children, children living in poverty had the largest increases in asthma and ADHD. Also, children with asthma and ADHD with 2 or more co-morbidities also significantly increased

Children in extreme poverty with asthma and ADHD had approximately twice the odds of having more than one comorbidity as compared to wealthier children. Children with asthma, ADHD, and autism with public insurance have significantly higher odds of having more than one co-morbid condition.

The study clearly establishes a strong correlation between an increase in poverty and a consequent increase in comorbidities. The research emphasizes on the need to ensure that these poor and often-neglected children receive the appropriate health services. There is an urgent need for policies that support practitioners, promote medical homes, and support children and families in poverty or near poverty to address their complex medical needs.

Pulcini elaborated on the importance of studying poverty and its impact on children’s health.

“Especially with the recent release of the American Academy of Pediatrics guidelines suggesting poverty screening as an essential component at every child health visit, we need to be aware that poor children already at greater risk for common childhood illnesses such as asthma, ADHD and autism often face even more medical conditions on top of these,” Pulcini said.