Asthma outcomes in children and adolescents with multiple morbidities: Findings from the National Health Interview Survey

Background: More Americans are managing multiple chronic conditions (MCCs), and trends are particularly alarming in youth. Objective: The purpose of this study was to examine the prevalence and distribution of 9 chronic conditions in children and adolescents with and without asthma, and adverse asthma outcomes associated with having MCCs. Methods: Cross-sectional interview data from the National Health Interview Survey were analyzed (N = 66,790) between 2007 and 2012 in youth 0 to 17 years of age. Bivariate analysis methods and multivariate generalized linear regression were used to examine associations. Results: Five percent of children with asthma had 1 or more coexisting health conditions. The prevalence of 1 or more comorbidities was greater among those with asthma than those without (5.07% [95% CI: 4.5-5.6] vs 2.73% [95% CI: 2.6-2.9]). Those with asthma were twice as likely to have co-occurring hypertension (prevalence ratio [PR] 52.2 [95% CI: 1.5-3.2]) and arthritis (PR 5 2.7 [95% CI: 1.8-4.0]) compared with those without asthma. Every additional chronic condition with asthma was associated with a greater likelihood of an asthma attack (PR 5 1.1 [95% CI: 1.0-1.2]), all-cause emergency department visits (PR 5 1.3 [95% CI: 1.1-1.5]), and missed school days (PR 5 2.3 [95% CI: 1.7-3.2]). Conclusions: Children and adolescents with asthma in the US who suffer from MCCs have increased asthma symptoms, missed school days, and all-cause emergency department visits. Further research on optimal management strategies for this group is needed.