Asthma Among Adults in Puerto Rico,

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1 Asthma Among Adults in Puerto Rico, Chronic Disease Division Puerto Rico Department of Health August, 2015

2 Objectives Background Data Source Objectives Present asthma mortality rates in Puerto Rico Present and compare asthma prevalence among adults by covariates in Puerto Rico and the United States Present and compare data related to uncontrolled asthma among adults in Puerto Rico and the United States

3 Objectives Background Data Source Asthma Asthma is a complex chronic disorder characterized by episodes of airflow obstruction, bronchial hyper-responsiveness, and an underlying inflammation, which are often reversible either spontaneously or with treatment (NAEPP, 2007). Represents a load to government, health care systems, caregivers and patients (Masoli, 2004) Patients with asthma have impaired quality of life (Ford, 2003)

4 Objectives Background Data Source Vital Statistics Responsable of collecting all the birth and deaths in the US Analyze all the deaths certificates to determine cause of death There are approximately 30,000 deaths by year in Puerto Rico Data from where aggregated to have a better representation when stratifying by specific conditions.

5 Objectives Background Data Source BRFSS Puerto Rico Behavioral Risk Factor Surveillance Survey World largest Random Dial Telephone Survey Complex Sampling Survey for extrapolation More than 7,000 interviews per year Random Child Selection Over 1,000 children living in households per year

6 Objectives Background Data Source BRFSS Health Outcomes Adult current asthma prevalence: Do you still have asthma?

7 Objectives Background Data Source ACB Asthma Call-Back Comprehensive asthma health survey in adult with current asthma data aggregation 800 participants with current asthma

8 Objectives Background Data Source ACB Health Outcomes Asthma control: Calculated using the NAEPP Guidelines Intermitent asthma: Calculated using the NAEPP Guidelines (data not shown)

9 Figure: Asthma Mortality trend, Deaths per 1,000, Survey Year

10 Figure: Asthma Mortality by municipality, Mortality rate by municipality (per 1,000,000 people) Less than or more

11 Figure: Asthma Prevalence by region, Less than 8.7% 8.8% 10.2% 10.3% 10.5% 10.6 or more

12 Figure: Adult Among Adults in PR and USA, Prevalence * Country PR USA Survey Year 2 Crude Prevalence

13 Figure: among Adult by Gender, Prevalance * Male Gender Female

14 Figure: Among Adults by Age Group, Prevalence > Age Group

15 among Adults by Socio-Demographic Status

16 Figure: Among Adults by Employment Status, Prevalence * Employ Outwork Homemaker Student Retired Unablework Employment status

17 Figure: Among Adults by Annual Household Income, Prevalence * <15k 15k <25k 25k <35k 35k <50k 50+k Respondent Annual Income

18 Figure: Among Adults by Smoking Status, Prevalance * No Smoker Yes

19 Figure: Among Adults by Marital Status, Prevalence * Married Divorced Widowed Separated Never Married Unmarried Couple Respondent Marital Status

21 Figure: Overall Asthma Control Distribution, Prevalence * Well Controlled Not Well Controlled Very Poorly Controlled Overall

22 Figure: Days with Asthma Symptoms During the Last 30 Days, prev * Days with asthma symptoms in the last 30 days

23 Figure: Days with Difficulty to Stay Asleep because of Symptoms of Asthma during the Last 30 Days, prev * Days that couldn't sleep due to asthma symptoms in the last month

24 Figure: Limitation of Usual Activities Due to Asthma During the Past 12 Months, prev * Not at all A little A moderate amount A lot Activity limitation

25 Figure: Missed Work Days due to Asthma During the Past 12 Month, prev * Days that couldn't sleep due to asthma symptoms in the last month

26 Figure: Visited a Doctor or other Health Professional for a Routine Checkup for your Asthma, prev * Routine Checkup in last year

27 Discussion Next steps An estimated 10 of every 100 Puerto Rican adults currently have asthma Puerto Rico still has higher current asthma prevalence among children than the USA Data suggests that certain socio-demographic characteristics are associated to having a adults with asthma Almost a 50% of the adults in Puerto Rico with asthma, had their condition uncontrolled

28 Discussion Next steps Continue with analysis and procedures of health outcomes indicators in adults with asthma (ACB and Administrative data) Expand discussion surrounding previous research, peer reviews and policy implications Disseminate results

29 Asthma Group Dra. Madeline Reyes García Dra. Jessica Irizarry Ramos Sra. Wanda Hernández Sr. PR-BRFSS Dr. Ruby Serrano

Asthma Control in Puerto Rico,

Asthma Control in Puerto Rico, in Puerto Rico, 2011-2012 Puerto Rico Asthma Program Division for the Control and Prevention of Chronic Diseases Puerto Rico Department of Health June, 2015 Objectives Background NAEPP asthma control