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I very much appreciate the comments of Dr Stuart, in particular because this is precisely the kind of dialogue I hope to encourage in the clinical community. For any chronic condition associated with a subjective constellation of symptoms and clinical findings (of which asthma is only one example), perceptions of prevalence and race and class disparities are embedded within the cultural, social, and economic experiences of both parents and clinicians. Our current epidemiological picture of asthma, which is based almost entirely on surveys of parental reports, is therefore confounded by these phenomena, which Dr Stuart points out.
Roberts EM. "Does Your Child Have Asthma?" The Response Might Have a Hidden Agenda—Reply. Arch Pediatr Adolesc Med. 2004;158(3):291. doi:10.1001/archpedi.158.3.291-b