The rate of chronic health conditions among children in the United States increased from 12.8% in 1994 to 26.6% in 2006, for conditions such as obesity, asthma and behavior/learning problems, according to a study in the February 17 issue of JAMA.
Understanding prevalence and dynamics of chronic conditions on a national scale is important when designing health policy, making accurate clinical predictions and targeting interventions to prevent chronic conditions, according to background information in the article. Patterns of how childhood chronic conditions have changed over time have not been widely examined.
Jeanne Van Cleave, MD, of Mass General Hospital for Children, Boston, and colleagues estimated changes in prevalence, incidence, and rates of remission of broad categories of conditions using 3 consecutive cohorts of children and examined the prevalence of having a condition during any part of the 6-year study period, according to a news release. The researchers used data from the National Longitudinal Survey of Youth-Child Cohort (1988-2006), which consisted of 3 nationally representative cohorts of children. Children were ages 2 years through 8 years at the beginning of each study period, and the groups were followed up for 6 years, from 1988 to 1994.
Items on the survey included reports by a parent of a child having a health condition that limited activities or schooling or required medicine, special equipment or specialized health services and that lasted at least 12 months. Obesity was defined as a body mass index at or above the 95th percentile for age. Chronic conditions were grouped into 4 categories: obesity, asthma, other physical conditions and behavior/learning problems.
The researchers found that prevalence of any chronic condition, including obesity, increased with subsequent groups. The prevalence at the beginning of the study for group 2 (16.6%) and group 3 (25.2%) was higher compared with group 1 (11.2%). The end-study prevalence of any chronic health condition was 12.8% for group 1 in 1994, 25.1% for group 2 in 2000, and 26.6% for group 3 in 2006.
Having a chronic condition was dynamic over time. Combining all groups, 16.6% of children had any chronic condition at the beginning of the study, and 20.8% reported a chronic condition at the end of the study period. “However, only 7.4% of all children reported a chronic condition both at baseline and at the end of the study period; 13.4% of participants represented new cases. For 9.3% of children, a chronic condition was reported at baseline but remitted by the study’s end.”
Additionally, the prevalence of having a chronic condition during any part of the 6-year study period was highest for group 3 (51.5%), and there were higher rates among male, Hispanic and black youth.
“Chronic conditions in childhood are common and dynamic, underscoring the benefits of continuous, comprehensive health services for all children to adjust treatment of chronic conditions, promote remission, and prevent onset of new conditions. Future research should examine etiological differences between persistent and remitted cases,” the authors concluded.