Key Facts About. ASTHMA
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1 Key Facts About. ASTHMA Asthma is a serious lung disease that can be frightening and disabling. The public is becoming increasingly aware that more people, especially children, are suffering and dying from asthma. General An estimated 20.3 million Americans (6.3 million children under 18) currently have asthma. 1 Of those 20.3 million Americans, 12 million people (4 million under 18) had an asthma attack in In the United States, 4,222 people died from asthma in By 2020, asthma is expected to strike 1 in 14 Americans and 1 in 5 families. 4 A recent survey indicated that approximately 7.1 percent of adults residing in the United States reported having asthma. Maine and Massachusetts had the highest percentage of adults with asthma (9.4%) while Louisiana and South Dakota had the lowest (5.3%). 5 Globally, up to 150 million people suffer from asthma. Worldwide, deaths from asthma have reached more than 180,000 annually. 6 Children, Schools and Child Care Asthma is the leading serious chronic illness of children. 7 Asthma is the number one cause of school absences attributed to chronic illnesses, leading to an average of 3.7school days missed annually per child. Asthma accounts for a total of 14 million lost school days each year. 8 Approximately 24 percent of children aged 5-17 years have some amount of activity limitation caused by asthma. 9 Asthma is the third cause of hospitalization among children under age Schools may be home to many common asthma triggers, including indoor air pollution. Indoor air quality (IAQ) problems in those settings can contribute to a child s asthma symptoms and the need for access to asthma medications. Many states
2 1 require that asthma medications be dispensed by a school nurse. The National Association of School Nurses recommends a minimum ratio of 1 school nurse for every 750 students (1:750). 11 Child care settings also may harbor common asthma triggers. In 1999, 5.1 million (60%) children ages 3-5 years were in child care. 12 Children with asthma, as well as other students, are at increased risk when outdoor air quality exceeds federal, health-based air quality standards. In 2000, 2 million children suffering from asthma attacks lived in counties that received an F grade for ozone air pollution. 13 Minority Populations In 2000, African American children were three to four times more likely than white children to be hospitalized and five times more likely to seek care for asthma at an emergency room. 14,15 African American children were more than three times as likely to die from asthma than white children in A disproportionate number of minority children live in areas with high ozone levels. Approximately 61.3 percent of African-American children, 69.2 percent of Hispanic children and 67.7 percent of Asian-American children live in areas that exceed the 0.08 parts per million federal ozone standard. By comparison, 50.8 percent of white children live in such areas. 17 Women have higher asthma s prevalence rate than men. In 2001, 11.7 million females had asthma compared to 8.6 million males. The prevalence rate in females was 30% greater that the rate in males. 18 Puerto Ricans have higher death rates from asthma, compared with other Hispanic subgroups as well as whites and African Americans. 19 Puerto Ricans also have higher rates of asthma prevalence than other Hispanic subgroups, especially in the Northeast. 20 Health Care Asthma attacks bring more than 1.8 million Americans to this nation s already overburdened emergency rooms each year. 21 Asthma is responsible for over 450,000 hospitalizations a year. 22 In 2000, some 9.3 million physician office visits were made for asthma. 23 Asthma costs the United States an estimated total of $14 billion annually, including $9.4 billion in direct costs such as hospitalization and $4.6 billion in indirect costs such as lost days of work. 24
3 In 1998, 41 percent of families with asthmatic children were classified as having no primary health insurance. 25 To fully meet the needs of patients with asthma, health care plans must provide access to quality care, treatments and prescription medications. Yet, far too many Americans do not have access to quality health care services according to a 1999 survey of physicians and nurses by the Kaiser Family Foundation and the Harvard School of Public Health percent of physicians reported that a health plan had disapproved coverage for a prescription drug they believe a patient needed; 52 percent of physicians reported that a health plan denied a referral to a specialist; 60 percent of physicians reported a health plan denied a hospital stay for their patients; and 61 percent of physicians reported prescription drug denials as the most frequent type of denial. Tobacco A study conducted by the California Environmental Protection Agency found that exposure to ETS can induce or exacerbate asthma in children. The study 27 found ETS may cause between 1,000 and 3,000 new cases of asthma in children in California each year. ETS may exacerbate asthma in 48,000 to 120,000 children in California each year. The California study strongly reinforces an earlier, landmark 1992 risk assessment issued by the U.S. Environmental protection Agency (EPA). 28 The EPA assessment concluded that, nationally ETS may be responsible each year for the onset of between 8,000 and 26,000 new cases of asthma. ETS may exacerbate the asthma of 200,000 to 1,000,000 children each year. Exposure to ETS from parents smoking causes 150,000 to 300,000 lower respiratory tract infections per year in children under 18 months of age, resulting in 7,500 to 15,000 hospitalizations. Respiratory tract infections are a common trigger for asthma symptoms. Environment
4 Evidence increasingly shows that air pollution plays a major role as a trigger for asthma episodes. Specifically, exposure to fine particles, sulfur dioxide and ozone have been linked to an increase in patients use of asthma medication, emergency room visits and hospital admissions. 29 Nearly half of the U.S. population 137,206,767 (49%) lives in areas with unhealthy levels of ozone. More than 7.4 million adults and 2 million children suffering from asthma attacks live in counties that received an F grade for ozone for Power plant particle pollution is estimated to cause more than 603,000 asthma attacks per year, 366,000 of which could be avoided by cleaning up power plants. 31 Indoor air pollutants such as dust mites, molds, animal dander and insect (especially cockroach) matter have been strongly associated with increased respiratory problems for adults and children with asthma National Center for Health Statistics. National Health Interview Survey, Unpublished data Ibid. 3 National Center for Health Statistics. Deaths Preliminary Data, March 14, Pew Environmental Health Commission. Attack on Asthma: Why America Needs a Public Health Defense System To Battle Environmental Threats. May Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance Survey, World Health Organization. Bronchial Asthma. WHO Fact Sheet Number 206. Revised January An Economic Evaluation of Asthma in the United States. The New England Journal of Medicine. Vol. 326: is deleted, please renumber all bullets. I can t seem to do it. 8 Centers for Disease Control and Prevention. Surveillance for Asthma United States, Morbidity and Mortality Weekly Report. Vol. 51 (SS01): March Ibid. 10 National Center for Health Statistics. National Hospital Discharge Survey, National Association of School Nurses. Caseload Assignments. Position Statement R National Center for Educational Statistics. Digest of Education Statistics. National Household Education Survey, 1991, 1995, August American Lung Association. American Lung Association State of the Air, May National Center for Health Statistics. National Hospital Discharge Survey, National Center for Health Statistics. Emergency Department Summary of the National Hospital Ambulatory Medicare Care Survey, National Center for Health Statistics. Report of Final Mortality Statistics, Vol. 50, No American Lung Association. Danger Zones: Ozone Air Pollution and Our Children National Center for Health Statistics. National Health Interview Survey, Unpublished data Homa, D., et al. Asthma Mortality in U.S. Hispanics of Mexican, Puerto Rican and Cuban Heritage, American Journal of Respiratory Critical Care Medicine. Vol. 161: Ledogar, R., et al. Asthma and Latino Cultures: Different Prevalence Reported Among Groups Sharing the Same Environment. American Journal of Public Health. Vol. 90, No National Center for Health Statistics. Emergency Department Summary of the National Hospital Ambulatory Medical Care Survey, National Center for Health Statistics. National Hospital Discharge Survey, National Center for Health Statistics. Emergency Department Summary of the National Hospital Ambulatory Medical Care Survey, 2000.
5 24 National Heart, Lung and Blood Institute Morbidity and Mortality Chart Book on Cardiovascular, Lung and Blood Diseases. May Lozano, et al. The Economic Burden of Asthma in U.S. Children, Estimates from the National Medical Expenditure Survey. Journal of Allergy and Clinical Immunology. Vol. 104, No Kaiser Family Foundation/Harvard School of Public Health. Study of Physician and Nurses: Randomly Selected Verbatim Descriptions from Physicians and Nurses of Health Decisions Resulting in Declines in Patients Health Status. July California Environmental Protection Agency. Health Effects of Environmental Tobacco Smoke. CalEPA Office of Environmental Health Hazard Assessment. October U.S. Environmental Protection Agency. Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders EPA. Smog Who Does It Hurt? What You Need to Know about Ozone and Your Health American Lung Association. American Lung Association State of the Air, May Clear the Air Task Force. The Particulate-Related Health Benefits of Reducing Power Plant Emissions. October The Role of Cockroach Allergy and Exposure to Cockroach Allergen in Causing Morbidity Among Inner City Children with Asthma. New England Journal of Medicine Vol. 336, No. 19. May 8, 1997.
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