Introduction

The relationship between socio-economic status and asthma is not clearly defined. A recent review paper [Mielck A, Reitmeir P, Wjst M. Severity of childhood asthma by socio-economic status. Int J Epid 1996 25 No 2 388-393] noted that while a number of studies had found a link between asthma and low-socio economic status an equal number of studies did not find any such relationship. The aims of this study were to assess if socio-economic status influences the severity of asthma and whether children from different social backgrounds utilise Health Services in the same manner.

Method

A group of 1504 children aged 1-15, with asthma or asthma like symptoms, identified from a previous study [Bryce FP et al Controlled trial audit. BMJ 1995 310 838-844] received standard medical care for asthma over a 4 year period. An index of deprivation based on 1991 census data was assigned to each child by home postcode. The identified cohort were divided into quartiles based on this index of deprivation. Group 1 contained the children from the most affluent background and deprivation increased to Group 4 which represented the children with the lowest socio-economic status. Severity of asthma was classified by BTS Treatment Steps and the patterns of care in general practice and the hospital setting were also examined.

Results

The data shows no influence of socio-economic status on BTS treatment step to which individual children were assigned (Table 1). Children in the affluent social groups attended their GPs more often for routine review of their asthma, although patient initiated consultations were similar for all groups. Socially deprived children had a higher rate of attendance at hospital outpatient clinics and were admitted to hospital more often than their prosperous contemporaries. (Table 2)

Conclusion

Severity of asthma as classified by BTS treatment Steps does not appear to be related to socio-economic status for this identified cohort. However socio-economic status appears to influence patterns of Health Service utilisation. Children with adverse social circumstances receive less preventative follow up care in general practice and a consequence of this may be more hospital admissions and outpatient attendances.