Asthma and Depression in Rural Teen Girls

Teen girls in rural areas more often have undiagnosed asthma than their male counterparts, and are at an additional higher risk for depression.

Undiagnosed asthma is more common in teen girls than boys who live in rural areas, and often they have a higher risk for depression, according to findings presented at the recent American Academy of Allergy, Asthma, and Immunology Annual Meeting.

Researchers from the Medical College of Georgia at Georgia Regents University collected 3 years’ worth of data from an asthma program targeted at teens in order to test whether the prevalence of both diagnosed and undiagnosed asthma was similar in boys and girls of urban and rural areas. The data was collected from 2,523 students between the years 2010 and 2013. The rates of diagnosed and undiagnosed asthma together were similar among teens living in urban in rural areas; however, more girls had undiagnosed asthma than the boys did.

“There’s a lot of speculation about why females are more likely to be undiagnosed,” Jeana Bush, MD, an MCG Allergy and Immunology Fellow, explained in a press release. “Maybe it’s because boys are more likely to get a sports physical for athletics and they catch it then. Or maybe it’s because girls attribute asthma symptoms to something else, like anxiety. That needs further study.”

Asthmatic teens in rural areas also demonstrated higher levels of depression compared to national averages. Using the Depression Intensity Scale Circles questionnaire, the researchers surveyed 332 asthmatic boys and girls in rural areas of Georgia. About a quarter of the participants screened positive for depression (87 total teens). Of those teens, 67 were females.

“The overall percentage of depression is higher than has been shown in the literature for other chronic diseases, including inflammatory bowel disease, diabetes, congenital heart disease, and even among cancer survivors,” Bush continued. “That was staggering.”

So far, researchers do not understand the association between asthma and depression, but Bush believes that it is a potential target area to combat asthma.

“Adolescents who are depressed may be less likely to talk about their symptoms or may attribute them to something else,” said Bush. “And so much of asthma treatment is about self management — figuring out your symptoms and preventing an attack when you recognize those symptoms. If you’re depressed, you are less likely to be aware of and have the ability to interpret those symptoms.”

The investigators attribute the higher rates of asthma in rural areas to a variety of factors, including poor housing quality, air pollution, trouble getting to doctors, smaller/ less equipped hospitals, and more exposure to tobacco. The researchers noted that smoking is more prevalent in rural areas than inner cities, as well.