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Poverty, Other Risks Explain Asthma's Link to Poor Achievement

The parents and teachers of children with chronic asthma can breathe a little easier: A massive study of more than 12,000 children in the United Kingdom found that asthma on its own was not linked to lower academic achievement.

Asthma is one of the most common chronic childhood illnesses, and it has been linked to higher rates of school absenteeism, and from there to lower grades and test scores. Children in poverty and from minority groups are disproportionately more likely to have asthma, and also disproportionately more likely to attend schools with lower indoor air quality.

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However, researchers from Queen Mary University of London, University of Edinburgh, and Mayhew Harper Associates suggest academic problems are not connected to the children's asthma on its own, but only in relation to other risk factors, such as poverty or being from an ethnic minority group.

In the study, released this morning in the online edition of the medical journal PLOS One, the team of researchers linked the clinical and education data for 12,136 students ages 5 to 14 who had taken at least one national test from 2002 to 2005. They found lower test scores for students with mental health or special education needs, Bangladeshi ethnicity, and "social adversity," including living in a smoking household (which increases the likelihood of more asthmatic episodes), and living in public-assistance housing or qualifying for free school meals.

When you stripped all those potential ancillary risk factors away, having asthma was actually associated with a 1.1 percent increase in test scores. Perhaps students stuck at home were studying more, or have more attentive adults around them? There's no way to tell from the data, but the data do show that helping children with asthma succeed in school requires more comprehensive interventions than a HEPA filter and an inhaler.

A few years back I reported on district efforts to reduce absenteeism, and met one Baltimore principal who partnered with her local health clinic to offer parents and students asthma response classes, and she asked for extra support from teachers and janitors to tamp down on any potential asthma triggers—but that was part of a schoolwide, multifaceted program to keep kids in school and ensure they made up for every missed day.

The study authors advocate for that sort of holistic approach. "We wanted to test whether asthma is linked with poorer academic achievement, as this could affect a child's chances of success later on in life. Instead we found children with asthma did as well as, or slightly better than, their peers in these tests," said Chris Griffiths, a co-author of the study and a primary care professor at the Blizard Institute, part of Queen Mary University of London, in a statement. "These findings will reassure parents of children with asthma—and teachers. Policymakers should target social deprivation and ethnicity in order to improve our children's educational attainment."

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