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It takes your breath away. More than 20 million Americans have asthma, 6.3 million of them children, and African-American children are affected at a rate 26 percent higher than children of other racial groups. And asthma is a growing problem — between 1980 and 1994 it increased more than 160 percent in children under the age of five. Minority children also are less likely to be using vital medications that prevent asthma attacks than are their white counterparts — even when health insurance is comparable.

Two ongoing research studies conducted by faculty at the Schools of Medicine and Public Health are looking for ways to better prevent and treat asthma in minority and low-income children.

Barbara Bokhour, a School of Public Health assistant professor of health services and a researcher at the Center for Health Quality, Outcomes, and Economic Research at the ENRM Veterans Hospital in Bedford, Mass., and Lauren Smith, an assistant professor of pediatrics at the School of Medicine, are part of a team working to improve communication and decision-making for families with asthmatic children. The researchers are engaged in a three-year study funded by the National Institute of Child Health and Human Development to explore communication between providers and parents from different ethnic backgrounds.

Previous research has indicated that both underprescribing by physicians and nonadherence by families contribute to the underuse of preventive medications in minority children. By learning how asthma is understood in the African-American and Latino cultures, and by clarifying patterns of communication among parents, children, and health-care providers in these communities, the researchers hope to design culturally sensitive interventions that will allow children to be more effectively treated.

A different approach, known as the Healthy Public Housing Initiative, is also under way. It is guided by Patricia Hynes, an SPH professor of environmental health, and colleagues at Tufts University School of Medicine, Harvard University School of Public Health, the Boston Housing Authority, the Committee for Boston Public Housing, the West Broadway and Franklin Hill Tenant Task Forces, and the Boston Public Health Commission. The initiative employs and trains public housing residents so that they can work collaboratively with university researchers to assess environmental conditions, test interventions, evaluate results, and develop action plans to create a healthier environment in their communities. One of the most important goals of the program is to develop strategies to minimize asthma triggers in the environment. By testing the effectiveness of asthma-related interventions such as air filters, new mattresses, heavy-duty cleaning, integrated pest management, and family education, the initiative is improving the lives of residents as well as making a valuable contribution to the understanding of asthma and the environment. Further information about this project is available on Hynes’ Web site:

Smile, it’s breakfast time. For young children, eating a good breakfast may be a key component of a beautiful smile, according to new research by Jonathan Shenkin, an SDM assistant clinical professor. Shenkin and a team of researchers from the University of Iowa College of Dentistry and the National Center for Health Statistics of the Centers for Disease Control and Prevention (NCHS/CDC) analyzed data — including dental exams and responses to questions about eating habits — from more than 4,000 children age two through five. They found that young children who ate breakfast daily — and/or ate more than five servings of fruits and vegetables per day — developed fewer dental caries in their primary (baby) teeth than did those who skipped breakfast, fruits, and vegetables.

The authors report that although dental decay has dropped markedly since the 1970s, 60 percent of children under the age of five still have at least one decayed tooth — and 20 percent of the children in that age range account for most of the decay.

Contrary to what might be expected, it was children from families that are not considered poor (above 200 percent of the federally defined poverty level) whose eating habits put them most at risk for tooth decay. The researchers note that many children from low-income families, who might otherwise be at higher risk, attend Head Start and related programs where they receive free or subsidized meals, particularly breakfast.

In the face of a 10 percent drop in the number of children eating breakfast in the past 30 years and a twofold increase in the consumption of sugar-containing soft drinks during the same period, the authors suggest that dental health professionals “. . . encourage parents, primary caregivers, and policy-makers to promote healthful eating practices, such as eating breakfast daily, for young children.”

The study was based on data from the third National Health and Nutrition Examination Survey conducted by the NCHS/CDC from 1988 to 1994. The research was reported in the January 2004 issue of the Journal of the American Dental Association.

"Research Briefs" is written by Joan Schwartz in the Office of the Provost. To read more about BU research, visit


15 May 2003
Boston University
Office of University Relations