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National surveillance for asthma - United States, 1980-2004. MMWR Surveill Summ

Division of Environmental Hazards and Health Effects, National Center for Environmental Health, CDC, Atlanta, Georgia 30333, USA.
MMWR. Surveillance summaries: Morbidity and mortality weekly report. Surveillance summaries / CDC 11/2007; 56(8):1-54.
Source: PubMed

ABSTRACT Asthma, a chronic respiratory disease with episodic symptoms, increased in prevalence during 1980-1996 in the United States. Asthma has been the focus of numerous provider interventions (e.g., improving adherence to asthma guidelines) and public health interventions during recent years. Although the etiology of asthma is unknown, adherence to medical treatment regimen and environmental management should reduce the occurrence of exacerbations and lessen the hardship of this disease. CDC has outlined a public health approach to asthma that includes comprehensive analyses of national surveillance data on prevalence, health-care use and mortality, and a strategy to improve the timeliness and geographic specificity of asthma surveillance data.
This report presents national data on asthma for self-reported prevalence (1980-1996 and 2001-2004); self-reported attacks (1997-2004); visits to physicians' offices (1980-2004), hospital outpatient departments (1992-2004), and emergency departments (1992-2004); hospitalizations (1980-2004); and deaths (1980-2004).
The National Health Interview Survey includes questions about asthma prevalence and asthma attacks. Physicians' office visit data are collected in the National Ambulatory Medical Care Survey, emergency department and hospital outpatient data in the National Hospital Ambulatory Medical Care Survey, hospitalization data in the National Hospital Discharge Survey, and death data in the Mortality component of the National Vital Statistics System.
From 1980 to 1996, 12-month asthma prevalence increased both in counts and rates, but no discernable change was identified in asthma attack estimates since 1997 or in current asthma prevalence from 2001 to 2004. During the period of increasing prevalence, patient encounters (office visits, emergency department visits, outpatient visits, and hospitalizations) for asthma increased. However, rates for these encounters, when based on the population with asthma, did not increase. Although the rate of asthma deaths increased during 1980-1995, the rate of deaths has decreased each year since 2000. During 2001-2003, current asthma prevalence was higher in children (8.5%) compared with adults (6.7%), females (8.1%) compared with males (6.2%), blacks (9.2%) compared with whites (6.9%), those of Puerto Rican descent (14.5%) compared with those of Mexican descent (3.9%), those below the federal poverty level (10.3%) compared with those at or above the federal poverty level (6.4% to 7.9%), and those residing in the Northeast (8.1%) compared with those residing in other regions (6.7% to 7.5%). Among persons with current asthma, whites and blacks were equally likely to report an attack during the preceding 12 months. Women with current asthma were more likely to report asthma attacks than men, and children were more likely than adults. The rate for asthma health-care encounters, regardless of place (physician office, emergency department, outpatient department, or hospital), when based on the population with asthma, did not differ by race. However, whites with current asthma had higher rates for physician offices, and blacks had higher rates for hospital-based sites (e.g., outpatient clinics and emergency departments).
The findings in this report suggest that from 1980 through the mid-1990s, increases in asthma prevalence played a substantial role in the increases in patient encounter measures used in asthma surveillance. Because no primary strategies for preventing asthma have been identified, efforts to control asthma exacerbations through interventions that promote adhering to proper medical regimens and reducing exposures to causes of asthma exacerbations should continue to be pursued.

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    • "Asthma in children and adolescents has increased in prevalence in recent decades and has become a major public health issue in developed and developing countries (Eder et al., 2006; Hansen et al., 2013; Moorman et al., 2007; Soriano et al., 2003; Wehrmeister et al., 2012; Yan et al., 2005). In the United States, the prevalence of asthma in children and adolescents has doubled from approximately 3.5% in early 1980 to 8.5% in early 2000 (Moorman et al., 2007), and 5.6 million school-age children and adolescents were reported to have asthma in 2006. In Norway, a questionnaire-based survey among children aged 7e14 years showed a significantly increasing prevalence of asthma, from 7.3% in 1985 to 17.6% in 2008 (Hansen et al., 2013). "
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    • "Asthma is a major public health problem. Its worldwide prevalence is estimated at 10% and is still increasing [1] [2] [3] [4]. Small percentage of asthmatic patients (5–10%) are not well controlled despite the use of high dose inhaled corticosteroids (ICS), long acting bronchodilators (LABA), plus add on treatment. "
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