Why Are US Children with Cystic Fibrosis Improving Faster than Canadian Kids?

Why are US children with cystic fibrosis improving faster than Canadian kids? Newborn screenings and child healthcare programs may be behind the improvement among US children with cystic fibrosis.

There’s a lot of talk about healthcare systems these days. Often pundits look to Canada’s public healthcare system as an preferred option to America’s free-market insurance plans. However, when it comes to children with cystic fibrosis, the US is getting something right — although it very well may be due to the US’s own public health programs.

New research from the  University of Washington School of Medicine comparing cystic fibrosis patients in the United States and Canada showed that, although the patients’ nutritional status and lung function improved in both countries over the period from 1990 to 2013, the rate of improvement was faster in the United States.

Nutritional status and lung function are closely related to survival in people living with cystic fibrosis, an inherited disease that affects the respiratory and digestive systems. To learn more about cystic fibrosis, click here.

The study, funded by the U.S. Cystic Fibrosis Foundation, used data from 37,772 patients in the U.S. Cystic Fibrosis Foundation Registry and 5,149 patients in the Canadian Cystic Fibrosis Registry. The study compared changes in the two counties in lung function and body mass index among CF patients.

Evidence indicates that maintaining weight is a key prognostic marker in cystic fibrosis and nutritional failure is a serious problem in the disease. People with cystic fibrosis born after 1990 in the U.S. have better nutritional status now compared to their counterparts in Canada.

Lung function, another key measure of health in cystic fibrosis, improved in both the United States and Canada. However, the rate of improvement in lung function was greater in all age groups in the United States compared to Canada.

Comparisons were made among forced expiratory volume (FEV) (how much air a person can exhale during a forced breath). The study indicated that U.S. children ages 6 – 18 years had increased FEV by almost 40% higher  in the United States compared to Canada.

The faster rate of improvement in lung function and nutrition in the United States, the researchers suggested, may be due to earlier implementation of newborn screening or quality improvement initiatives for the disease and improved access to medical care under the Medicaid Children’s Health Insurance Program (CHIP) in the United States. The program provides health coverage to children in families whose household income is too high to qualify for Medicaid, but who cannot afford private coverage.

“The findings from this study are encouraging in that they support positive trends in the health of people with CF in both Canada and the U.S., ” said Dr. Bruce Marshall, lead study investigator for the Cystic Fibrosis Foundation and senior vice-president of clinical affairs for the organization.

“As a community, we can all take pride in these improvements while continuing to learn as much as we can to slow down the progression of this disease and improve the quality of life for all those living with it.”

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