Vital Signs: Asthma Prevalence, Disease Characteristics, and Self-Management Education --- United States, 2001--2009

Vital Signs: Asthma Prevalence, Disease Characteristics, and Self-Management Education --- United States, 2001--2009
Weekly
May 6, 2011 / 60(17);547-552




On May 3, this report was posted as an MMWR Early Release on the MMWR website (http://www.cdc.gov/mmwr).

Abstract
Background: Most persons with asthma can be symptom-free if they receive appropriate medical care, use inhaled corticosteroids when prescribed, and modify their environment to reduce or eliminate exposure to allergens and irritants. This report reviews recent progress in managing asthma and reducing its prevalence in the United States.

Methods: CDC analyzed asthma data from the 2001--2009 National Health Interview Survey concerning children and adults, and from the 2001, 2005, and 2009 state-based Behavioral Risk Factor Surveillance System concerning adults.

Results: Among persons of all ages, the prevalence of asthma increased from 7.3% (20.3 million persons) in 2001 to 8.2% (24.6 million persons) in 2009, a 12.3% increase. Prevalence among children (persons aged <18 years) was 9.6%, and was highest among poor children (13.5%) and among non-Hispanic black children (17.0%). Prevalence among adults was 7.7%, and was greatest in women (9.7%) and in adults who were poor (10.6%). More uninsured persons with asthma than insured could not afford to buy prescription medications (40.3% versus 11.5%), and fewer uninsured persons reported seeing or talking with a primary-care physician (58.8% versus 85.6%) or specialist (19.5% versus 36.9%). Among persons with asthma, 34.2% reported being given a written asthma action plan, and 68.1% had been taught the appropriate response to symptoms of an asthma attack. Only about one third of children or adults were using long-term control medicine such as inhaled corticosteroids at the time of the survey.

Conclusions and Comment: Persons with asthma need to have access to health care and appropriate medications and use them. They also need to learn self-management skills and practice evidence-based interventions that reduce environmental risk factors.

Introduction

Asthma is a chronic respiratory disease that affects persons of all ages and is characterized by episodic and reversible attacks of wheezing, chest tightness, shortness of breath, and coughing (1). Although asthma cannot be cured at present, symptoms can be controlled with appropriate medical treatment, self-management education, and by avoiding exposure to environmental allergens and irritants that can trigger an attack (1,2). The most current evidence-based guidelines for the diagnosis and management of asthma were developed by an expert panel commissioned by the National Asthma Education and Prevention Program (NAEPP), coordinated by the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH) (2). The NAEPP guidelines focus on four key components of asthma care to improve the quality of care and health outcomes of persons with asthma: 1) assessment and monitoring, 2) patient education, 3) control of factors contributing to asthma severity, and 4) medical treatment. These guidelines indicated that, among other long-term control medications for asthma, inhaled corticosteroids were the most potent and consistently effective long-term control medication (2).

In the United States, national survey data indicate persistent demographic differences in asthma prevalence, with rates disproportionately greater among children, women, blacks, and those reporting income below the federal poverty level (FPL) (3--6). Although most persons with asthma can be free of symptoms with appropriate management, poor asthma control continues to be associated with increased emergency department visits, hospitalizations, and medical costs (2,7). The estimated total cost of asthma to society, including medical expenses ($50.1 billion per year), loss of productivity resulting from missed school or work days ($3.8 billion per year), and premature death ($2.1 billion per year) was $56 billion (2009 dollars) in 2007; a $3 billion (5.7%) increase from 2002. Medical expenses associated with asthma were $3,259 per person per year during 2002--2007 (7). This report updates U.S. asthma prevalence estimates and describes trends, disease characteristics, and self-management education status among persons who have asthma.

full-text:
Vital Signs: Asthma Prevalence, Disease Characteristics, and Self-Management Education --- United States, 2001--2009