Youngstown among worst asthma cities in U.S.

Youngstown is eighth out of the 15 worst asthma cities in the nation.
By WILLIAM K. ALCORN
VINDICATOR STAFF WRITER
YOUNGSTOWN -- Simple Asthma Control Tests for children 12 and older and for children ages 4 to 11 years of age are crucial keys to successfully treating the disease, said Dr. Jonathan P. Parsons, assistant professor of medicine at Ohio State University.
The ultimate goal is to get children's ACTs done in school and then get the results to parents and pediatricians so they can better treat and care for the asthmatic child, said Dr. Parsons, staff pulmonologist at the OSU Asthma Center.
The Asthma Control Tests helps assess symptoms and encourage patient-physician and patient-parent communication, said Dr. Parsons, also co-investigator for the American Lung Association Asthma Clinical Research Network.
Dr. Parsons spoke Monday at a Youngstown City Council Education Committee meeting at Chaney High School on asthma among schoolchildren. The meeting was a cooperative effort among Youngstown City Schools, council's education committee, and GlaxoSmithKline, a pharmaceutical company. It was chaired by 4th Ward Councilwoman Carol Rimedio-Righetti.
Big problem in Ohio
Asthma is a public health crisis in Ohio and the nation. But, as illustrated by a study by the Asthma and Allergy Foundation of American, five out of 15 of the worst asthma cities in the nation are in Ohio, including Youngstown, which is rated eighth.
Asthma is a chronic disease of the respiratory system in which the airway occasionally constricts, becomes inflamed, and is lined with excessive amounts of mucus, often in response to one or more triggers.
Triggers may include tobacco smoke -- the worst offender, said Dr. Parsons -- dust mites, molds, animal dander, cockroach allergen, exercise, viral infections such as those that cause the common cold, and occupational exposures.
Symptoms, depending on severity of the asthma, include varying degrees of recurrent wheezing, cough, and tightness of the chest, Dr. Parsons said.
There are deaths every year from asthma, which Dr. Parsons said "should never happen."
Also, he said it is "ridiculous" that nearly 25 percent of Ohio children with asthma had an emergency room visit during 2004, and "scary" that 50.6 percent of children with asthma had attacks during 2004.
Among the culprits are parents and health-care providers who sometimes underestimate the severity of asthma in their children and patients, he said.
Action plan
In addition to the ACT tests, Dr. Parsons said an asthma action plan should be mandatory for all children with asthma in school. He said children who have symptom-based written action plans have fewer acute-care visits.
Dr. Parsons also recommended that every school have rescue inhalers immediately available and a peak flow meter, which tests the lung's capacity to move air.
Schools Superintendent Wendy Webb said Youngstown has inhalers in each school, but not flow meters.
Dr. Parsons said the asthma crisis is particularly serious in the black community, particularly among black women. He said blacks are three times as likely than whites to be hospitalized and/or die from asthma, and black women have the highest mortality rate of all groups.
He said the disparities are highly correlated to environmental issues, such as poverty, poor urban air quality, indoor allergens, the lack of patient education and inadequate medical care.
alcorn@vindy.com