"Does Your Child Have Asthma?" The Response Might Have a Hidden Agenda

The article, "Does Your Child Have Asthma?," by Roberts,¹ reported several interesting conclusions. One finding, that parental reports may underestimate the prevalence of serious asthma among poor children, is the exact opposite of my experience. I am a pediatrician practicing in a rural town in Florida. The parents of virtually 100% of my African American patients report, without any history taking, that their child(ren) has (have) asthma. My thoughts on the matter: parents are indoctrinated into our welfare system by claiming this illness for their child. The area Social Security offices do little in terms of substantiating the diagnosis, and the children wind up with with Supplementary Security Income and, unfortunately for the child, a medical condition. Once these children become regular patients of mine, I have the opportunity to assess these children over time. The great majority never have a need for bronchodilator therapy or preventitive medicine. My experience over the last 8 years has taught me that economically disadvantaged families will report "asthma" as a diagnosis in even their 3-day-old newborns. If I challenge the diagnosis or inquire about the lack of a work-up, I risk the parent moving on to a new doctor.