You asked for (1) data on childhood asthma for Connecticut counties and (2) information on the relationship between asthma and cockroaches and low-income housing.

Enclosed is OLR report 2002-R-0064, which provides a statistical overview of childhood asthma in Connecticut.

ASTHMA RATES BY COUNTY

Asthma rates among elementary school children vary from 9. 7% in Windham County down to 6. 3% in Fairfield County, according to a report released in 2000 by Environment and Human Health, Inc. (EHHI), a nonprofit organization based in North Haven that researches and advocates on environmental health issues (A Survey of the Prevalence of Asthma Among School Age Children in Connecticut http: //ehhi. org/pubs/Asthma. pdf).

Table 1 shows the percentage of elementary pupils with asthma by county.

EHHI gathered data from school nurses about the number of students known to have a diagnosis of asthma and, of those, the number receiving asthma medication in school. Researchers received data on 513,688 K-12 students in 138 school districts, but they analyzed and reported only elementary and K-8 school data because of "greater variability in the data at the middle and high school levels. " This methodology does not conform to the way the federal Centers of Disease Control and Prevention (CDC) measure asthma prevalence. It uses asthma diagnosis and attack prevalence over a 12-month period. Consequently, it produces lower estimates of prevalence.

ASTHMA, COCKROACHES, AND INCOME

The domestic cockroach has been identified as a source of indoor allergens throughout the world. A 1997 study by Dr. David Rosenstreich of the Albert Einstein Institute of Medicine in New York and others concluded that exposure to high levels of cockroach allergy "may help to explain the frequency of asthma-related health problems in inner-city children. "The study, published in the New England Journal of Medicine (May 1997), looked at 476 children in eight inner-city areas. The researchers tested the children for sensitivity to cockroach, dust mite, and cat allergens and tested their homes for the presence of these allergens.

The study found 36. 8% of the children were allergic to cockroaches, 34. 9% to dust mites, and 22. 7% to cats. In the children's bedrooms researchers found 50. 7% had high levels of cockroach allergen, 9. 7% had high levels of dust mite allergens, and 12. 6% had high levels of cat allergen. After adjusting for sex, behaviors, and family history of asthma, the researchers found that children who were both allergic to cockroach allergen and exposed to high levels of it had 0. 37 hospitalizations a year, as compared to 0. 11 for other children, and 2. 65 unscheduled medical visits for asthma per year, compared with 1. 43 for other children. They also had significantly more days of wheezing, missed school days, and nights with lost sleep. The study did not find similar patterns for the combination of allergy to dust mites and cat dander and high levels of those allergens.

Although asthma affects Americans of all ages, races and ethnic groups, low income and minority populations experience significantly higher rates of fatalities, hospital admissions, and emergency room visits due to the disease, the U. S. Department of Health and Human Services reports. From 1993-1995, there were an average of 38. 5 deaths per million from asthma in African-Americans compared to 15. 1 per million in whites. In 1995, African-Americans were more than four times more likely than whites to visit an emergency room because of asthma. The prevalence of asthma is also high among some populations of Hispanics, with those of Puerto Rican descent having the highest incidence. Hospitalization and death rates for Hispanic children due to asthma in New York City are three times higher than the national average. Although asthma was once considered rare among American Indians and Alaska Natives, studies have shown that asthma prevalence is increasing in this group. Indian children appear to be especially affected, with prevalence rates as high as 12%.

Numerous factors may contribute to these data, but housing is a potential component. Poverty forces families to live in substandard housing, whether urban, suburban, or rural. Older homes, or those in crowded areas, give cockroaches a fertile breeding ground. Roaches are particularly difficult to eradicate in multi-family dwellings; cleaning them out of one unit usually just drives them into another, and it is only a matter of time before they return. Low-income housing may have other qualities associated with high asthma rates: uncontrollable heating systems, poor ventilation, and water damage that lead to mold growth. Overcrowded conditions can also create more of the humid conditions (more showering and cooking) in which cockroaches thrive. And low-income housing may also be located in neighborhoods that contain high concentrations of other asthma triggers, like vehicle exhaust.

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