The Commonwealth of Kentucky has one of the highest rates of smoking in the United States. In addition, the prevalence rates of both adult and childhood asthma are above average when compared with the rest of the nation. While many states have comprehensive tobacco and smoke free school policies, Kentucky does not. Only 28% of school districts in Kentucky have enacted tobacco free policies. The purpose of this study is to begin to explore the possible link between tobacco free schools and childhood asthma.
METHODS:
For this preliminary analysis of childhood asthma and tobacco free schools, childhood asthma prevalence was calculated using 2012 and 2014 Ky BRFSS at the Administrative Development District (ADD) level due to unstable rates at the county level. Enrollment data and raw parent reported asthma rates were obtained from the Kentucky Department of Education through Infinite Campus. This data was used to calculate the percent of students attending tobacco free schools at the county and ADD levels. Asthma prevalence and proportion of students attending tobacco free schools were then compared. Choropleth maps at the county and ADD levels were also created to better communicate the data visually.
RESULTS:
The Spearman correlation coefficient between the percent of students not attending a tobacco free school and the unadjusted asthma rates based on enrollment data at the county level was -0.12594 (p-value = 0.1705) The Spearman correlation coefficient between the percent of students not attending a tobacco free school and the estimated BRFSS prevalence of childhood asthma at the ADD level was 0.11081 (p-value = 0.6942).
CONCLUSIONS:
No significant link between tobacco free school policies and childhood asthma prevalence was found in this preliminary analysis. This was not surprising given the spatial aggregation of the data and the oversimplification of the relationship between asthma and tobacco smoke. Further analysis may provide better insight into the connection between tobacco policies and childhood asthma in Kentucky. As hospitalization data becomes available to our group, future analyses will attempt to focus on asthma hospitalizations due to a more direct link between asthma exacerbations and smoke exposure.