Asthma Causes In Texas Still A Mystery, But Young Practitioners May Offer Hope

Diana, a young mother in Dallas, was devastated when she discovered her four-year-old son had asthma. She kept thinking she could have done something - maybe even while she was pregnant - to have prevented it. "I've heard drinking cow's milk and eating eggs while you're pregnant can cause it. I don't know. You always wonder."

While there have been controversial studies suggesting this, the data is not conclusive, and many physicians disregard it. In all actuality, Diana's story is, unfortunately, not uncommon. Incidences of asthma have increased dramatically in the last two decades, and we're still not sure why.

Children, particularly those living in the inner cities in Dallas, Houston and other Texas cities, seem to be particularly affected. Of the 20 million people in the United States who suffer from asthma, 6 million are children. From 1980 to 2003, the prevalence of asthma in children increased by 60%; from 1980 to 1994, the prevalence in children under five increased 160%.

That means those young ones at the beginning of this flux are now in the health care system as adult's practitioners, patients - and dealing with all the insurance issues that come with it. Approximately 5,000 in the U.S. die from the disease every year, and deaths worldwide could increase by 20% over the next ten years. Clearly, something is not right.

So what's going on? Part of the problem is that, while Texans and people throughout the rest of the country get swept up in the latest health scare - bird flu, West Nile virus, Lyme's disease, whatever - the true killers garner less attention. Though asthma is a constant problem growing worse, the fluxes in Lyme's disease on the East Coast, or a bad season of the West Nile virus in between North Dakota and Texas, are the stories that grab the media's attention. The truth is, twenty times more people die from asthma every year than those who died from West Nile in its peak season.

The other problem, of course, is that for as long as asthma's been around, still, no one's sure what causes it. And that's frustrating, particularly for the increasing number of adults who have been dealing with it their whole lives. It could be environmental, genetic, symptoms of allergies, poor nutrition, weight gain, stress; it could be exposure, or lack of exposure, to microbes - it could be a combination of all, or a few factors, and (just to make it even more interesting), it's probably different for everyone.

Asthma is considered an autoimmune disorder, and, like all autoimmune disorders, complicated. Therefore, it's difficult for science to pinpoint sure causes. These conditions are a combination of reactions between the internal processes of the body and the sensitive and varied external processes of the world at large. Environmental factors have been the focus, as genetics do not evolve quickly enough to affect such a mass population so quickly.

Roughly half of all asthma cases are believed to be caused by allergies, but that just begs the question: What's causing such an increase in allergies, then? Tobacco smoke and pollution are easy targets, but data doesn't pinpoint them specifically.

While individuals diagnosed with asthma have increased throughout Texas and nationally, many areas of the country have actually experienced a decrease in pollution, and, while there has been a recent increase in the rate of smokers, those numbers, too, have generally decreased since the '70's. One study suggested that women who did not receive adequate amounts of Vitamin E during their pregnancy could cause the disease in their children.

The higher percentage of inner-city children affected also provides an interesting spike in the data; exposure to diesel fumes and cockroaches might be to blame. Obesity may be the culprit; there is a correlation between obesity and asthma, and the (also) dramatic increase in childhood obesity would seem to confirm this - but, once again, the link is not yet clear. The majority of the health care community now believes that most asthma cases are caused by multiple factors, but identifying the possible multiple causes for each case is a different story.

Perhaps encouraged by more young adults open to different suggestions, possibly also a result of more young practitioners in the field, more and more attention is being given to the role of emotional states as a likely cause of the increase in treated asthma cases, or at least as an enhancement of many conditions. Utilizing a writing exercise created by Dr. James Pennebaker of the University of Texas at Austin, a young Dr. Joshua Smythe conducted a double-blind study of chronic asthma and rheumatoid arthritis patients while at the State University of New York (Stony Brook School of Medicine).

The study included 107 patients afflicted with mild-to-moderately severe asthma or rheumatoid arthritis. One group (the variable) was instructed to write for a continuous twenty minutes about "the most stressful event they had ever undergone" for three consecutive days, while the control group wrote only about neutral events for the same time period. After four months, the variable group was twice as likely to have improved, and over five times as likely to have not degenerated. It was significant enough for the assistant professor to warrant considerable attention, and to open up the health community to considering more integrated approaches to treating patients with chronic conditions.

Since the cause of the dramatic increase in asthma cases being treated during the past two decades has gone more or less unsolved, children affected by the pandemic in its early days are not only entering the health care system as adult asthma patients, but also as health care practitioners with asthma. This provides for an interesting twist that was rare twenty-five years ago: asthma patients studying and treating their own group. The insights this may provide could prove invaluable as we discover better methods of research, data collection, and diagnosis, and become more open to the possibilities of integrated approaches.

So, once again, we see that young adults may be our greatest hope "those entering the medical and research fields with sharp, edgy minds open to possibility, backed by the advantages of not only the latest advances, but also by the motivation of personal experience" either through their own suffering or the suffering of a loved one. The growing asthma pandemic may not be solved yet, but we now have perhaps the strongest ally in the fight to date: personal experience.