Sal Mangione, M.D., associate professor of medicine at Jefferson Medical College of Thomas Jefferson University in Philadelphia, and his co-workers there compared the prevalence and severity of asthma between middle school students in schools run by the Philadelphia School District and those administered by Edison, Inc., a management company designated by the school district to run nearly one-half of its lowest academically performing schools.
In earlier research, Dr. Mangione and his co-workers had studied inner-city schools in Philadelphia to gauge the prevalence and awareness of asthma among 5th and 6th grade schoolchildren, finding that schools were greatly underestimating the prevalence of asthma. The researchers decided to try to find out if the incidence and severity of the disease differed between Edison and other Philadelphia schools.
"If these kids were doing poorly in school, maybe asthma and resulting absenteeism was the issue," he says. "Asthma is the number one cause of absenteeism in schools. The question was, were these kids sicker than the others, and not just poorer students? These were kids from more disadvantaged economic areas, which are breeding grounds for asthma. The assumption was, there would be more asthma."
Dr. Mangione's group screened 6,727 middle school students from 65 Philadelphia public schools: 6006 managed by the school district and 721 by Edison. They used a self-administered video questionnaire depicting five symptoms of asthma.
The two groups did not differ in their reporting of asthma: 23.7 percent of the school district children and 24.5 percent of the Edison children said they had asthma.